case_images: PMC8254158_01
case_images: Plain computed tomography head showing right-sided intracerebral hemorrhage with extension to the ventricles
case_images: HV-22-45-g001.jpg
case_images: PMC8254158_06_HV-22-45-g001.jpg
case_images: F1
case_images: The surgery was done by putting the patient on cardiac bypass machine, and incision was made in the main pulmonary artery and a long strand of thrombus was manually retrieved from the main, right, and left pulmonary arteries [Figure 4 and Supplemental Video 1]; then, the main pulmonary artery was sutured closed.
case_images: PMC8254158_02
case_images: Twelve-lead electrocardiogram showing sinus tachycardia with incomplete right bundle branch block
case_images: HV-22-45-g002.jpg
case_images: PMC8254158_02_HV-22-45-g002.jpg
case_images: F2
case_images: Electrocardiogram (ECG) showed sinus tachycardia with incomplete right bundle branch block pattern [Figure 2].
case_images: PMC8254158_03
case_images: Computed tomography pulmonary angiogram showing large saddle embolus producing a filling defect within the main left and right pulmonary arteries
case_images: HV-22-45-g003.jpg
case_images: PMC8254158_03_HV-22-45-g003.jpg
case_images: F3
case_images: A follow-up CT pulmonary angiogram showed large saddle embolus producing a filling defect within the main left and right pulmonary arteries [Figure 3].
case_images: PMC8254158_04
case_images: PMC8254158_05
case_images: PMC8254158_06
case_images: Plain computed tomography head showing right-sided intracerebral hemorrhage with extension to the ventricles
case_images: HV-22-45-g001.jpg
case_images: PMC8254158_06_HV-22-45-g001.jpg
case_images: F1
case_images: The surgery was done by putting the patient on cardiac bypass machine, and incision was made in the main pulmonary artery and a long strand of thrombus was manually retrieved from the main, right, and left pulmonary arteries [Figure 4 and Supplemental Video 1]; then, the main pulmonary artery was sutured closed.
case_images: Gross image during surgical embolectomy of large pulmonary embolism. (a) Successful manual removal of large thrombus strand through small incision in the main pulmonary artery. (b) Removed
case_images: HV-22-45-g004.jpg
case_images: PMC8254158_06_HV-22-45-g004.jpg
case_images: F4
case_images: The surgery was done by putting the patient on cardiac bypass machine, and incision was made in the main pulmonary artery and a long strand of thrombus was manually retrieved from the main, right, and left pulmonary arteries [Figure 4 and Supplemental Video 1]; then, the main pulmonary artery was sutured closed.
case_images: Intraoperative transesophageal echocardiography with bubble injection showing bubbles leaking from right to left atrium through patent foramen ovale (blue line)
case_images: HV-22-45-g005.jpg
case_images: PMC8254158_06_HV-22-45-g005.jpg
case_images: F5
case_images: The patient had an incidentally found patent foramen ovale on intraoperative transesophageal echocardiography (TEE) which was closed also during the surgery [Figure 5] with prolene sutures.
case_images: Follow-up computed tomographic pulmonary angiography showing clearance of the saddle embolus with residual small thrombus (blue arrow) in the right segmental pulmonary artery
case_images: HV-22-45-g006.jpg
case_images: PMC8254158_06_HV-22-45-g006.jpg
case_images: F6
case_images: Follow-up CT scan was done 4 days after the surgery and showed clearance of the saddle embolus with small residual thrombus in the right main pulmonary artery and bilateral segmental branch [Figure 6].
case_images: Follow-up magnetic resonance imaging showing normalization of right ventricular size and function
case_images: HV-22-45-g007.jpg
case_images: PMC8254158_06_HV-22-45-g007.jpg
case_images: F7
case_images: It showed normalization of RV volume and function [Figure 7], indexed end-diastolic RV volume of 42 ml/m2, and indexed end-systolic RV volume of 22 ml/m2 with RV ejection fraction of 48%.
case_images: PMC8254158_07