PARADOXICAL EMBOLI AFTER PULMONARY EMBOLU S - A SERIES OF 6 CASES

Among a series of 6 patients who had paradoxical emboli after pulmonar y embolus, thrombus was encrusted in the foramen ovale in 2 while cont rast echocardiography showed a free foramen ovale in the 4 others. Sur gical embolectomy was performed in 1 of the patients with a thrombus i n the foramen ovale. This patient died in the post-operative period an d the second patient died suddenly before the indication for surgery h ad been established. The 4 other patients were treated medically with anticoagulant therapy. After a follow-up of 37, 33, 32 and 3 months re spectively none of these patients has developed recurrent emboli. The association of a thromboembolic disease and a systemic ischaemic event should strongly suggest the diagnosis of paradoxical embolus. Echocar diography is required to determine whether the foramen ovale is free o r harbours a thrombus.