A 69-year-old man was admitted with an acute pulmonary thromboembolism and a snake-shaped embolus captive in the patent foramen ovale. An emergent surgical extraction of the thromboembolus on cardio-pulmonary bypass was done.
Despite of a performed pulmonary embolectomy by serious right heart failure in postoperative course the patient died and the autopsy confirmed the presence of a massive, fresh pulmonary embolism.