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A Journal on Surgery

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Chirurgia 2006 October;19(5):363-5

language: English

Surgical treatment of mobile right atrial thrombus and pulmonary embolism due to protein C deficiency associated with patent foramen ovale

Onem G. 1, Vefa Ozcan A. 1, Sacar M. 1, Evrengul H. 2, Baltalarli A. 1

1 Pamukkale University Department of Cardiovascular Surgery Denizli, Turkey
2 Pamukkale University Department of Cardiology Denizli, Turkey


We present a case of a 36-year-old woman suffering from mobile right atrial thrombus and pulmonary embolism associated with cardiogenic shock. Two-dimensional echocardiography demonstrated a mass in the right atrium prolapsing through the tricuspid valve into the right ventricle during diastole, and leading to partial inflow obstruction. Computed tomography revealed a large mass into the left and right main pulmonary artery leading to obstruction. The laboratory findings of the patients revealed protein C deficiency. An emergency operation was performed and the thrombus in the right atrium and both pulmonary arteries were successfully extracted with using cardiopulmonary bypass. Previously unsuspected a large patent foramen ovale was closed primarily. This exemplary case highlights the benefit of surgical intervention rather than more conservative approaches such as anticoagulation and/or thrombolysis.

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