Renal infarction caused by paradoxical embolism through a patent foramen ovale

Abstract

A 48-year-old man presented with acute right flank pain. A computed tomography scan revealed right renal infarction. Because he had no thrombosis in the renal vessels and no clear embolic source, a further examination was performed to find the cause of the renal infarction. On transesophageal echocardiography, a right-to-left shunt during the Valsalva maneuver established a diagnosis of patent foramen ovale. This is a case of paradoxical embolism through a PFO leading to renal infarction.

Case report: Renal infarction by paradoxical embolism through the patent foramen ovale as an unusual cause of post-operative abdominal pain after sleeve gastrectomy

“…Post-operative pain from renal infarction has been recently reported, but in this case arose from thrombus formation in a resected pulmonary vein stump and hence, not a true paradoxical emboli [6]. Only a limited number of paradoxical renal emboli have been reported and usually present as spontaneous, not post-operative, abdominal pain [7], [8], [9]. PFO occurs in 25–35% of the population and is usually asymptomatic but can cause cryptogenic stroke, migraine, platypnea-orthodeoxia syndrome and air embolism during decompression sickness in divers [10].…”

Successful rescue from kidney failure with delayed catheter-directed intervention after catastrophic bilateral kidney paradoxical thromboembolism

“…Case reports of bilateral renal infarction from paradoxical emboli are rare 4–7. Carey et al reported a patient with bilateral renal artery occlusion in the setting of a deep vein thrombosis and PFO who remained dialysis dependent 4.…”

“…Case reports of bilateral renal infarction from paradoxical emboli are rare. [4][5][6][7] Carey et al reported a patient with bilateral renal artery occlusion in the setting of a deep vein thrombosis and PFO who remained dialysis dependent. 4 In the case by Herbaut et al, the infarcted kidney was not salvageable after a significant delay in diagnosis and treatment.…”

“…Figure5 Multiple fragments of embolic material were successfully retrieved from the renal arteries during suction thrombectomy.…”

From kidney to kidney: an unusual case of paradoxical embolism through a patent foramen ovale

“…1d). Paradoxical renal thromboembolic events -although rare -are already reported in literature, 2,3 while PFO is a well known cardiac source of embolism, especially in case of right atrial pressure increase. 4,5 In our case, the clinical picture suggested that an abrupt increase in PAPs due to paraneoplastic pulmonary embolism created a paradoxical embolization in the kidneys through an otherwise silent PFO.…”