Li JD, Xu N, Zhao Q, Li B, Li L. Multiple paradoxical embolisms caused by central venous catheter thrombus passing through a patent foramen ovale: A case report. World J Clin Cases 2024; 12(4): 842-846 [PMID: 38322689 DOI: 10.12998/wjcc.v12.i4.842]
Corresponding Author of This Article
Li Li, MD, Chief Doctor, Department of Cardiology, Guangzhou Red Cross Hospital of Jinan University, No. 396 Tongfu Middle Road, Haizhu District, Guangzhou 510235, Guangdong Province, China. lilygs@ext.jnu.edu.cn
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Feb 6, 2024; 12(4): 842-846 Published online Feb 6, 2024. doi: 10.12998/wjcc.v12.i4.842
Multiple paradoxical embolisms caused by central venous catheter thrombus passing through a patent foramen ovale: A case report
Jian-Duan Li, Nian Xu, Qiang Zhao, Biao Li, Li Li
Jian-Duan Li, Nian Xu, Qiang Zhao, Biao Li, Li Li, Department of Cardiology, Guangzhou Red Cross Hospital of Jinan University, Guangzhou 510235, Guangdong Province, China
Co-first authors: Jian-Duan Li and Nian Xu.
Author contributions: Li JD contributed to conceptualization and investigation, and manuscript writing; Xu N contributed to Investigation and editing; Li JD and Xu N contribute equally to this study, they share co-first author; Zhao Q contributed to investigation and resources; Li B contributed to resources and editing; Li L contributed to conceptualization and editing; all authors have read and approved the final manuscript.
Supported byNatural Science Foundation of Guangdong Province, No. 2021A1515011267; and Guangzhou Municipal Science and Technology Bureau, No. 2023A03J0984.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li Li, MD, Chief Doctor, Department of Cardiology, Guangzhou Red Cross Hospital of Jinan University, No. 396 Tongfu Middle Road, Haizhu District, Guangzhou 510235, Guangdong Province, China. lilygs@ext.jnu.edu.cn
Received: October 25, 2023 Peer-review started: October 25, 2023 First decision: December 15, 2023 Revised: December 27, 2023 Accepted: January 15, 2024 Article in press: January 15, 2024 Published online: February 6, 2024 Processing time: 91 Days and 20 Hours
Abstract
BACKGROUND
To date, this is the first case of a paradoxical embolism (PDE) that concurrently manifested in the coronary and lower limb arteries and was secondary to a central venous catheter (CVC) thrombus via a patent foramen ovale (PFO).
CASE SUMMARY
Here, we report a case of simultaneous coronary and lower limb artery embolism in a PFO patient carrier of a CVC. The patient presented to the hospital with acute chest pain and lower limb fatigue. Doppler ultrasound showed a large thrombus in the right internal jugular vein, precisely at the tip of the CVC. Transthoracic and transesophageal echocardiography confirmed the existence of a PFO, with inducible right-to-left shunting by the Valsalva maneuver. The patient was administered an extended course of anticoagulation therapy, and then the CVC was successfully removed. Percutaneous PFO closure was not undertaken. There was no recurrence during follow-up.
CONCLUSION
Thus, CVC-associated thrombosis is a potential source for multiple PDE in PFO patients.
Core Tip: Paradoxical coronary embolism is a rare cause of acute myocardial infarction. Here, we report a case of simultaneous coronary and lower limb artery embolism in a patent foramen ovale (PFO) patient carrier of a central venous catheter (CVC). CVC-associated thrombosis is a potential source for paradoxical embolisms in PFO patients. Meanwhile, transesophageal echocardiography can help us detect PFOs more accurately.
