Acute Pulmonary Embolism and Paradoxical Embolism in Patients with Patent Foramen Ovale: to Close or Not to Close…That is the Question!

Abstract

<p>Nowadays, the treatment of patent foramen ovale (PFO) after acute pulmonary embolism (PE) remains matter of speculation. Absence of both randomized trials and recommendations in current international guidelines complicate the decisions making in such patients. In the present manuscript we discuss about the reasons for which PFO should be closed after acute PE.</p>

An Elderly Man with Syncope, Hypoxia, and Confusion: A Case Report and Review of Literature

“…The optimal management of patients with paradoxical embolism from PFO remains controversial. Zuin et al suggested that for patients with thrombophilia and PFO, the transcatheter closure of PFO, along with chronic oral anticoagulation, is recommended [3]. Data from long-term studies involving large patient populations for percutaneous PFO closure are still lacking.…”

“…The optimal management of patients with paradoxical embolism from PFO is challenging. It must be individualized based on the potential benefits and risks considering the patients' comorbidities along with procedural complications [3]. We report an elderly patient who presented with an acute sub-massive PE treated with thrombolytic therapy and had a paradoxical embolism and ischemic stroke as a result of a clot traversing through a PFO.…”