Böhm A, Hricak V, Kozlovsky M, Sumbal J, Majerckik M, Tomasovic B, Baranova E, Pec J.
Case description: A 49-year-old male was transferred to CCU with recent massive, but hemodynamically stable, pulmonary embolism (PE) followed by symptomatic embolic stroke 3 days before the CCU admission. TEE echocardiography showed thrombus in foramen ovale (PFO), CCD Ultrasonography showed thrombi in the right popliteal vein. Emergent surgical thrombectomy and PFO closure were successfully performed. However the postoperative period was complicated by hemodynamic instability requiring ECMOECLS, recurrent massive PE, infection with disseminated intravascular coagulopathy and diffuse bleeding on continual heparin treatment. After multiple surgical revisions, hemotherapy and antibiotic treatment bleeding was stabilized and the infection subsided. The patient was discharged with minimal neurologic deficit and hemodynamically stabilized.