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

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

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


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.

Copyright © 2010 Elsevier Inc. All rights reserved.

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