Paradoxical embolization in an adult cystic fibrosis patient

Cystic fibrosis patients, with an implantable venous access device (IVAD) and a patient foramen ovale (PFO) are at increased risk of developing paradoxical embolism. A 33-year-old patient who had a cerebrovascular accident in the above setting is described. She had been anticoagulated because she had thrombosis of the tip of the indwelling catheter, and her PFO was closed percutaneously followed by replacement of her IVAD. She made a full neurological recovery. Echocardiography and prophylactic closure of the PFO, when present as primary prevention for paradoxical embolism may be warranted in cystic fibrosis patients before placement of an IVAD.