{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T20:02:54Z","timestamp":1787169774945,"version":"build-2736575974"},"reference-count":6,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>Although a patent foramen ovale (PFO) is relatively common, confirmed reports of thrombus entrapped within a PFO are uncommon. Management of impending paradoxical embolism (IPE), also called a thrombus in transit, lacks consensus but includes systemic anticoagulation (e.g., heparin), systemic thrombolysis, or surgical thrombectomy. We present a case of IPE diagnosed with intraoperative transesophageal echocardiography (TEE) as well as a novel en bloc approach to atrial septal aneurysmectomy to minimize embolism and facilitate repair of the interatrial septum. Timely use of intraoperative TEE may aid in diagnosis and help guide the surgical approach to minimize embolic risk with an IPE.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/aca.aca_186_20","type":"journal-article","created":{"date-parts":[[2023,3,31]],"date-time":"2023-03-31T06:13:05Z","timestamp":1680243185000},"page":"476-478","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Emergent Pulmonary Thromboembolectomy and Atrial Septal Aneurysmectomy for Intracardiac Impending Paradoxical Embolism"],"prefix":"10.4103","volume":"24","author":[{"given":"Allan M","family":"Klompas","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Greason","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger L","family":"Click","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William J","family":"Mauermann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-10-20240901","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1016\/j.acvd.2008.09.004","article-title":"The straddling atrial thrombus: From image to treatment","volume":"101","author":"Cabanes","year":"2008","journal-title":"Arch Cardiovasc Dis"},{"key":"R2-10-20240901","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1053\/j.jvca.2007.07.006","article-title":"Massive thrombus in transit detected by echocardiography","volume":"22","author":"Amin","year":"2008","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"R3-10-20240901","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1016\/j.acvd.2008.08.011","article-title":"Surgical or medical treatment for thrombus straddling the patent foramen ovale: Impending paradoxical embolism? Report of four clinical cases and literature review","volume":"101","author":"Fauveau","year":"2008","journal-title":"Arch Cardiovasc Dis"},{"key":"R4-10-20240901","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1378\/chest.09-0961","article-title":"Impending paradoxical embolism: Systematic review of prognostic factors and treatment","volume":"137","author":"Myers","year":"2010","journal-title":"Chest"},{"key":"R6-10-20240901","doi-asserted-by":"crossref","first-page":"31438","DOI":"10.3402\/jchimp.v6.31438","article-title":"Traversing boundaries: Thrombus in transit with paradoxical embolism","volume":"6","author":"Miriyala","year":"2016","journal-title":"J Community Hosp Intern Med Perspect"},{"key":"R7-10-20240901","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1111\/j.1540-8191.2010.01168.x","article-title":"Paradoxical embolus caught in transit through a patent foramen ovale","volume":"26","author":"Shah","year":"2011","journal-title":"J Card Surg"}],"container-title":["Annals of Cardiac Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/aca.ACA_186_20","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:12:50Z","timestamp":1787166770000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/aca.ACA_186_20"}},"subtitle":["An En Bloc Approach to Prevent Clot Embolism and Facilitate Repair"],"short-title":[],"issued":{"date-parts":[[2021,10]]},"references-count":6,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.4103\/aca.aca_186_20","relation":{},"ISSN":["0971-9784"],"issn-type":[{"value":"0971-9784","type":"print"}],"subject":[],"published":{"date-parts":[[2021,10]]}}}