MOVING PARADOXICAL EMBOLISM - THE IMPORTA NCE OF EARLY ECHOCARDIOGRAPHIC DIAGNOSIS

The paradoxical embolism or the crossing of an embolism through a perm eable foramen ovale is considered to be a rare mechanism of cerebral e mbolism although its real frequency is unknown, Reports demonstrating the embolism during its crossing through cardiac cavities are scarce, Two cases of moving paradoxical embolism are presented. In the first, an infarction of the superior branch of the left middle cerebral arter y was produced during the course of deep vein thrombosis and pulmonary thromboembolism with transesophageal echocardiography demonstrating t he crossing of the embolism through the foramen ovale. Surgery perform ed 12 days later did not discover the auricular thrombus, In the secon d case, a mass was discovered in the right auricle with a permeable fo ramen ovate during the course of a left middle cerebral artery infarct ion and a large auricular thrombus was demonstrated in surgery, The di agnostic usefulness of early transsesophageal echocardiography in the diagnosis of moving paradoxal embolism is discussed.