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  • Title: The role of thrombolytic therapy in the management of paradoxical embolism.
    Author: d'Audiffret A, Shenoy SS, Ricotta JJ, Dryjski M.
    Journal: Cardiovasc Surg; 1998 Jun; 6(3):302-6. PubMed ID: 9705104.
    Abstract:
    Paradoxical emboli are considered a rare event, representing less than 2% of all arterial emboli. The most common intracardiac defect associated with paradoxical emboli is a patent foramen ovale. Most commonly, a pulmonary embolism is the cause of the acute increase in right atrial pressure leading to a reversal of intracardiac flow and passage of venous embolic material to the left heart. We present a patient with a pulmonary embolism and paradoxical emboli, and discuss therapeutic approach. We suggest that the treatment of choice for the patient with pulmonary embolism and non-limb-threatening acute ischemia due to a paradoxical emboli should be thrombolytic therapy and intracaval filter placement, followed by patent foramen ovale repair.
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