Surgical treatment of high-risk pulmonary embolism associated with paradoxical embolism, complicated by acute cerebrovascular accident

Abstract

The article presents a case of successful surgical treatment of pulmonary embolism in a patient with a high risk of early cardiac death on the background of paradoxical embolism complicated by acute cerebrovascular accident. Cryptogenic acute cerebrovascular accident in combination with severe progressive right ventricular failure on the background of pulmonary embolism causes serious difficulties in making decisions regarding treatment tactics in these patients. Intracardiac localization of thromboemboli, threatened by the development of recurrent pulmonary embolism, as well as paradoxical embolism, requires immediate implementation of a differential diagnostic complex aimed at verifying the pathophysiological mechanism of the disease, which largely determines the effectiveness of the treatment. The analysis of the available literature data, given in the work, as well as the analysis of the clinical case, make it possible to develop a tactical algorithm in this group of patients and to determine the indications for open heart surgery.

Keywords

• paradoxical embolism
• pulmonary embolism
• cryptogenic stroke
• thrombectomy
• thrombosis