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Background <p>Impending paradoxical embolism (IPDE) involves venous thrombi crossing a patent foramen ovale, posing high risks of systemic embolization.</p> Case presentation <p>A 64-year-old male was admitted to the operation theater due to heart failure symptoms, with the original plan of undergoing atrial mass resection and mitral valve replacement. Intra—operative transesophageal echocardiography (TEE) diagnosed the patient with IPDE and acute pulmonary embolism. And this critical diagnosis immediately altered the surgical decision-making process, which included pulmonary artery thrombectomy. The successful treatment of this case was significantly attributed to the intraoperative TEE examination, which provided essential real—time diagnostic information guiding the surgical approach. This case highlighted the importance of intra-operative TEE in management of IPDE for surgical planning.</p> Conclusions <p>TEE is the final defense in IPDE. To optimize surgical outcomes and avert misdiagnosis, routine utilization of intraoperative TEE is highly recommended for similar cases.</p>

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Transesophageal echocardiography as the final defense in impending paradoxical embolism: a case report

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月18日

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  • Zhuangyuan Chen,
  • Mingjing Chen,
  • Haibo Song,
  • Yauwai Chan

摘要

Background

Impending paradoxical embolism (IPDE) involves venous thrombi crossing a patent foramen ovale, posing high risks of systemic embolization.

Case presentation

A 64-year-old male was admitted to the operation theater due to heart failure symptoms, with the original plan of undergoing atrial mass resection and mitral valve replacement. Intra—operative transesophageal echocardiography (TEE) diagnosed the patient with IPDE and acute pulmonary embolism. And this critical diagnosis immediately altered the surgical decision-making process, which included pulmonary artery thrombectomy. The successful treatment of this case was significantly attributed to the intraoperative TEE examination, which provided essential real—time diagnostic information guiding the surgical approach. This case highlighted the importance of intra-operative TEE in management of IPDE for surgical planning.

Conclusions

TEE is the final defense in IPDE. To optimize surgical outcomes and avert misdiagnosis, routine utilization of intraoperative TEE is highly recommended for similar cases.