Surgical embolectomy for paradoxical cerebral embolism with massive pulmonary embolism
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The patient was a 68-year-old woman with a history of multiple cerebral emboli. The patient presented with dysarthria, dysphagia, and left facial paralysis. Emergent MRI demonstrated multiple emboli in the brain stem and left occipital lobe. Echocardiography and chest CT demonstrated floating emboli entrapped in the foramen ovale and pulmonary emboli in both main pulmonary arteries. Emergent pulmonary embolectomy and extraction of the emboli on the foramen ovale were successfully performed without neurological exacerbation.
KeywordsPulmonary embolism Cerebral embolism Paradoxical embolism Pulmonary embolectomy Venous thromboembolism
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Conflict of interest
The authors declare they have no conflict of interest.
Supplementary material 1 Video 1. Transesophageal echocardiography shows a biatrial embolus entrapped in the patent foramen ovale. (MPG 23298 KB)
Supplementary material 2 Video 2. Intraoperative video. (MPG 18108 KB)