J Cardiovasc Ultrasound.  2015 Sep;23(3):177-180. 10.4250/jcu.2015.23.3.177.

Post-Operative Multiple Thrombosis Associated with Patent Foramen Ovale: Embolic Stroke, Right Atrial Thrombi, Pulmonary Embolism and Deep Vein Thrombosis

• Cho SY
• Youn HJ
• Park MY
• Shim BJ
• Lee SJ
• Kim JH
• Park JK
• Oh CY
• Ahn SH
• Cho WH

• KMID: 2068728
• DOI: http://doi.org/10.4250/jcu.2015.23.3.177

Abstract

Patients undergoing total joint arthroplasty frequently develop post-operative complication, such as deep vein thrombosis and pulmonary thromboembolism. However, it is not common coexisting deep vein thrombosis, pulmonary thromboembolisms, right atrial thrombus and acute cerebral infarction raised by thrombus through patent foramen ovale. We reported the patient who had multiple thrombi which were accompanied with a cryptogenic ischemic stroke and associated with patent foramen ovale after operation.

Keyword

Deep vein thrombosis; Pulmonary thromboembolism; Patent foramen ovale

MeSH Terms

Arthroplasty
Cerebral Infarction
Foramen Ovale, Patent*
Humans
Joints
Pulmonary Embolism*
Stroke*
Thrombosis*
Venous Thrombosis*

Figure

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  Fig. 1 An embolic infarction in right posterior temporal lobe is seen in diffusion brain magnetic resonance imaging (arrow).

• 

  Fig. 2 Transthoracic echocardiographic finding. A: D-shaped left ventricle is seen in the short axis view. B: Two thrombi (arrows) are present in the right atrium; and, the size of right atrium and right ventricle is enlarged (in four chamber view). C: Tricuspid regurgitation and severe pulmonary hypertension (pulmonary artery systolic pressure 102 mm Hg) are shown in the Doppler echocardiogram. D: Inferior vena cava is dilated (in subcostal view).

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  Fig. 3 Chest computed tomography (CT) angiogram. A and B: Thrombi (arrows) exist in both pulmonary arteries according to chest CT. C and D: Thrombi was not found at the follow up chest CT.

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  Fig. 4 The passage of microbubbles (arrows) from right atrium to left atrium is seen on the agitated saline test.

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