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Interesting Images

Trapped Thrombus in the Open Foramen Ovale

by
Sebastian Spethmann
1,*,
Fabian Knebel
1 and
Adrian Constantin Borges
2
1
Medizinische Klinik mit Schwerpunkt Kardiologie und Angiologie, Charité, Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
2
Helios Klinikum, Berlin, Germany
*
Author to whom correspondence should be addressed.
Cardiovasc. Med. 2011, 14(7), 229; https://doi.org/10.4414/cvm.2011.01602
Submission received: 10 May 2011 / Revised: 10 June 2011 / Accepted: 10 July 2011 / Published: 10 August 2011
A 73-year-old woman with history of malignant melanoma successfully treated 20 years previously presented to the emergency department with sudden dyspnoea and a swollen right leg. A deep venous thrombosis in the right common femoral vein was diagnosed. Based on the suspicion of a mass in the right atrium during a transthoracic echocardiography, a transoesophageal examination was performed, which showed a large thrombus trapped in a patent foramen ovale. The patient was referred to the Department of Cardiovascular Surgery for surgical thrombectomy. A Trendelenburg operation was adopted due to developing haemodynamic instability. During the heart surgery no intracardiac or intraaortic thrombus could be found. A patent foramen ovale was surgical closed and thrombectomy of old thrombus material in the pulmonary artery performed and anticoagulation with unfractionated heparin induced. An acute systemic embolism was ruled out by a computed tomography scan. The reasons for the deep venous thrombosis remained unknown. No clinical signs of recurrence of the malignant melanoma could be detected. The woman remained healthy and was discharged to a rehabilitation clinic.
Figure 1. The transoesophageal echocardiography showed a mobile thrombus trapped in a patent foramen ovale (PFO). LA, left atrium; RA, right atrium; AS, atrial septum.
Figure 1. The transoesophageal echocardiography showed a mobile thrombus trapped in a patent foramen ovale (PFO). LA, left atrium; RA, right atrium; AS, atrial septum.
Cardiovascmed 14 00229 g001
Figure 2. The mid oesophageal two chamber view showed the left atrial (LA) part of the thrombus. LV, left ventricle.
Figure 2. The mid oesophageal two chamber view showed the left atrial (LA) part of the thrombus. LV, left ventricle.
Cardiovascmed 14 00229 g002

Funding/Potential Competing Interests

No financial support and no other potential conflict of interest relevant to this article were reported.

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MDPI and ACS Style

Spethmann, S.; Knebel, F.; Borges, A.C. Trapped Thrombus in the Open Foramen Ovale. Cardiovasc. Med. 2011, 14, 229. https://doi.org/10.4414/cvm.2011.01602

AMA Style

Spethmann S, Knebel F, Borges AC. Trapped Thrombus in the Open Foramen Ovale. Cardiovascular Medicine. 2011; 14(7):229. https://doi.org/10.4414/cvm.2011.01602

Chicago/Turabian Style

Spethmann, Sebastian, Fabian Knebel, and Adrian Constantin Borges. 2011. "Trapped Thrombus in the Open Foramen Ovale" Cardiovascular Medicine 14, no. 7: 229. https://doi.org/10.4414/cvm.2011.01602

APA Style

Spethmann, S., Knebel, F., & Borges, A. C. (2011). Trapped Thrombus in the Open Foramen Ovale. Cardiovascular Medicine, 14(7), 229. https://doi.org/10.4414/cvm.2011.01602

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