Intraoperative identification of both a paradoxical embolism and its probable etiologic site

Journal of Clinical Anesthesia
Andrew B CasabiancaThomas J Papadimos

Abstract

We report a case of upper extremity arterial ischemia in a 41-year-old man. Intraoperative transesophageal echocardiography identified a paradoxical embolization that traversed a patent foramen ovale as the probable etiology. The diagnosis of paradoxical embolism with intraoperative identification of the etiologic site of the deep venous thrombosis is a rare event. This case presents the use of transesophageal echocardiography beyond its monitoring function in helping diagnose the cause of arterial ischemia.

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