Cholecystectomy in the presence of a large patent foramen ovale: laparoscopic or open?

Mark S Thoma; John Maa; Nelson B Schiller; Lawrence Litt

doi:10.1016/j.jclinane.2009.09.011

Cholecystectomy in the presence of a large patent foramen ovale: laparoscopic or open?

J Clin Anesth. 2010 Nov;22(7):553-6. doi: 10.1016/j.jclinane.2009.09.011.

Authors

Mark S Thoma¹, John Maa, Nelson B Schiller, Lawrence Litt

Affiliation

¹ Department of Anesthesia and Perioperative Care, the University of California, San Francisco, CA 94143-0648, USA.

PMID: 21056814
DOI: 10.1016/j.jclinane.2009.09.011

Abstract

An obese patient with cholelithiasis and acute cholecystitis was scheduled for an emergency laparoscopic cholecystectomy. On preoperative workup, a 5-year-old echocardiogram showed a large patent foramen ovale (PFO) with a right-to-left shunt that was open at rest. Noting both the benefits of laparoscopic surgery and the substantial incidence of PFO in the general population (10% to 30%), the attending and consulting surgeons reasoned that the benefits of laparoscopy greatly exceeded an immeasurably small risk of paradoxical emboli.

Publication types

Case Reports
Research Support, Non-U.S. Gov't

MeSH terms

Cholecystectomy, Laparoscopic / adverse effects
Cholecystectomy, Laparoscopic / methods*
Cholecystitis, Acute / surgery*
Cholelithiasis / surgery
Embolism, Paradoxical / etiology
Female
Foramen Ovale, Patent / complications*
Foramen Ovale, Patent / epidemiology
Humans
Middle Aged
Obesity / complications