RESUMO
Thrombus straddling a patent foramen ovale and massive pulmonary embolism is a very rare and life-threatening condition. Optimal management can be controversial because different therapeutic options are available and individual approach based in individual risk is needed. We present a case of a thrombus straddling the patent foramen ovale with massive pulmonary embolism, hemodynamic instability, and upper extremity embolism. We performed surgical pulmonary embolectomy, and venous arterial extracorporeal membrane oxygenation was needed to successfully overcome severe right ventricular impairment and pulmonary injury.
Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Embolectomia/métodos , Oxigenação por Membrana Extracorpórea/métodos , Forame Oval Patente/complicações , Ventrículos do Coração , Embolia Pulmonar/complicações , Trombose/etiologia , Ecocardiografia , Ecocardiografia Transesofagiana , Feminino , Forame Oval Patente/diagnóstico , Forame Oval Patente/cirurgia , Cardiopatias/diagnóstico , Cardiopatias/etiologia , Cardiopatias/cirurgia , Humanos , Pessoa de Meia-Idade , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/cirurgia , Trombose/diagnóstico , Trombose/cirurgia , Tomografia Computadorizada por Raios XRESUMO
Pulmonary regurgitation is the most important sequellae after correction of Tetralogy of Fallot and has a considerable impact over the right ventricle. Surgery has demonstrated low early mortality after pulmonary valve replacement and good long-term outcomes, remaining nowadays the gold standard treatment of pulmonary regurgitation in rTOF patients. Nevertheless, transcatheter pulmonary valve implantation has emerged as a new, safe and efficient alternative to surgical valve replacement. In this review article, we try to evaluate and compare both techniques to find out which is the best therapeutic option in this patients.