Open AccessPFO closure consideration for refractory hypoxia and secondary prevention of recurrent arterial thromboembolism
Author(s) -
David Maksimovich,
Cihan Çevik,
Christopher Merrick
Publication year - 2019
Publication title -
the southwest respiratory and critical care chronicles
Language(s) - English
Resource type - Journals
ISSN - 2325-9205
DOI - 10.12746/swrccc.v7i31.579
Subject(s) - medicine , patent foramen ovale , paradoxical embolism , intracardiac injection , thrombosis , shunt (medical) , cardiology , right to left shunt , surgery , hypoxia (environmental) , venous thrombosis , occlusion , refractory (planetary science) , anesthesia , chemistry , percutaneous , organic chemistry , oxygen , physics , astrobiology
Acute arterial and deep venous thrombosis presenting simultaneously are uncommon medical emergencies, usually secondary to an underlying cause. We present a 64-year-old woman with concurrent bilateral pulmonary embolisms and acute thrombotic occlusion of the right brachial artery. Her work-up revealed a large patent foramen ovale (PFO), with a right to left intracardiac shunt and bilateral lower extremity deep venous thrombosis. The patient was unable to be weaned off mechanical ventilation due to her refractory hypoxia. However, after closure of the PFO the patient’s oxygenation improved. This case demonstrates the potential beneficial role of PFO closure in a hypoxic patient with a right to left intracardiac shunt. In addition, closure of the PFO may provide secondary prevention of paradoxical systemic thromboembolism.