PMID- 26357795
OWN - NLM
STAT- MEDLINE
DCOM- 20151001
LR  - 20181113
IS  - 0022-1058 (Print)
IS  - 0022-1058 (Linking)
VI  - 46
IP  - 3
DP  - 2014 Sep
TI  - An Unusual Case of Cannula Obstruction Resulting from Venous Thromboembolism.
PG  - 267-9
AB  - Cerebral strokes of unknown origin frequently present with a patent foramen ovale 
      (PFO), a common atrial septal defect occurring in approximately 25% of the adult 
      population. Deep vein thrombosis (DVT) or pulmonary embolism (PE) in the presence 
      of a PFO can produce paradoxical systemic embolization subsequent to an increase 
      in pulmonary pressure, permitting entry of thrombi into the arterial circulation. 
      Diagnosis of an impending paradoxical embolism (IPDE) involves the detection of 
      DVT or PE in the presence of an abnormal communication between left and right 
      circulations and may include a right-to-left shunt. Treatment includes oral 
      anticoagulation, antiplatelet agents, thrombolysis, transcatheter closure of the 
      defect, or surgical embolectomy and PFO closure. As a result of risks of 
      intracranial hemorrhage with fibrinolysis, pulmonary embolectomy using 
      cardiopulmonary bypass (CPB) and deep hypothermia is a primary treatment with a 
      surgical mortality rate at approximately 5%. Despite optimal management, IPDE is 
      associated with a mortality rate of 18%. Prompt diagnosis and treatment is 
      critical in avoiding systemic thromboembolization and strokes in these patients. 
      We report a case of superior vena cava cannula obstruction resulting from a 
      paradoxical embolus traversing a PFO during surgery. Warning signs and management 
      during CPB are discussed.
FAU - Ozdirik, Jessica E
AU  - Ozdirik JE
FAU - Grant, Peter W
AU  - Grant PW
FAU - Cheruvu, Chaitu
AU  - Cheruvu C
FAU - Bassin, Levi
AU  - Bassin L
FAU - Lahanas, Andrew
AU  - Lahanas A
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - France
TA  - J Extra Corpor Technol
JT  - The journal of extra-corporeal technology
JID - 0267637
MH  - Aged, 80 and over
MH  - Cardiopulmonary Bypass
MH  - Foramen Ovale, Patent/*complications
MH  - Humans
MH  - Male
MH  - Superior Vena Cava Syndrome/*etiology
MH  - Vascular Access Devices
MH  - Venous Thromboembolism/*complications
PMC - PMC4566838
COIS- The senior author has stated that the authors have reported no material, 
      financial, or other relationship with any healthcare-related business or other 
      entity whose products or services are discussed in this paper.
EDAT- 2015/09/12 06:00
MHDA- 2015/10/02 06:00
PMCR- 2014/09/01
CRDT- 2015/09/12 06:00
PHST- 2015/09/12 06:00 [entrez]
PHST- 2015/09/12 06:00 [pubmed]
PHST- 2015/10/02 06:00 [medline]
PHST- 2014/09/01 00:00 [pmc-release]
AID - ject.2014.46.3.267 [pii]
PST - ppublish
SO  - J Extra Corpor Technol. 2014 Sep;46(3):267-9.