{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T22:10:25Z","timestamp":1780524625004,"version":"3.54.1"},"reference-count":14,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2009,12,14]],"date-time":"2009-12-14T00:00:00Z","timestamp":1260748800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2010,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Patent foramen ovale (PFO) in the setting of venous thromboembolism is associated with paradoxical embolization. We describe a patient who presented with pulmonary embolism, underwent pulmonary embolectomy, and postoperatively developed paradoxical embolization to the lower extremity.<\/jats:p><jats:p>A 27\u2010year\u2010old African American male presented to the hospital with shortness of breath and midsternal chest pain along with neck vein distention. A CT scan with contrast showed the presence of a saddle embolus in both pulmonary arteries. The next day, the patient developed right ventricular failure and hypotension. The patient was taken to the operating room for a pulmonary embolectomy. Postoperatively, the patient developed acute left lower extremity ischemia. The origin of the embolus was suspected to be cardiac. A transesophageal echocardiogram (TEE) revealed thrombus on the mitral valve and a PFO with right to left shunt. At this point vascular surgery for revascularization of the left lower extremity was performed. Two days later, the patient was taken for a repeat cardiac surgery and the left\u2010sided thrombus was removed along with a closure of the PFO.<\/jats:p><jats:p>This case signifies the importance of complete TEE and a search for PFO in patients with massive pulmonary embolism especially prior to surgical embolectomy because hemodynamic disturbances of pulmonary embolism and surgical embolectomy may cause migration of the thrombus from the right side to the left side of the heart. Copyright \u00a9 2009 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/clc.20653","type":"journal-article","created":{"date-parts":[[2009,12,14]],"date-time":"2009-12-14T21:17:07Z","timestamp":1260825427000},"source":"Crossref","is-referenced-by-count":6,"title":["Massive Pulmonary Embolism and Paradoxical Migration during Surgical Embolectomy: Role of Transesophageal Echocardiogram"],"prefix":"10.1002","volume":"33","author":[{"given":"Haroon","family":"Chughtai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose","family":"Basora","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamrul","family":"Khan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jyoti","family":"Matta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2010,1,8]]},"reference":[{"key":"e_1_2_1_2_2","first-page":"23","volume-title":"Segmental Anatomy of the Lungs: Study of the Patterns of the Segmental Bronchi and Related Pulmonary Vessels","author":"Boyden EA","year":"1955"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1922.02640230014006"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.08.038"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/1752-1947-1-104"},{"key":"e_1_2_1_6_2","doi-asserted-by":"crossref","unstructured":"RobyDRakhit Patent foramen ovale (PFO) and paradoxical embolism Heart2003;89:1362.","DOI":"10.1136\/heart.89.11.1362"},{"key":"e_1_2_1_7_2","first-page":"380","article-title":"Prognostic value of echocardiography and spiral computed tomography in patients with pulmonary embolism","volume":"11","author":"Gibson NS","year":"2005","journal-title":"Curr Opin Pulm Med"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-136-9-200205070-00012"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199604000-00029"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000117284.25696.64"},{"key":"e_1_2_1_11_2","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1055\/s-0037-1612658","article-title":"Stroke in young adults: the role of paradoxical embolism","volume":"85","author":"Chant H","year":"2001","journal-title":"Thromb Haemost"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.121.3.877"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.111.3.537"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000012526.21603.25"},{"key":"e_1_2_1_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000029818.65521.A9"}],"container-title":["Clinical Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fclc.20653","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/clc.20653","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T14:46:57Z","timestamp":1700578017000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/clc.20653"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,1]]},"references-count":14,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2010,1]]}},"alternative-id":["10.1002\/clc.20653"],"URL":"https:\/\/doi.org\/10.1002\/clc.20653","archive":["Portico"],"relation":{},"ISSN":["0160-9289","1932-8737"],"issn-type":[{"value":"0160-9289","type":"print"},{"value":"1932-8737","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,1]]}}}