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Canadian Journal of Cardiology

Refractory Hypoxemia After Laparoscopic Nissen Fundoplication

      Abstract

      Postoperative hypoxemia can result from a variety of causes. We describe a case of platypnea-orthodeoxia caused by shunting across a patent foramen ovale in a 72-year-old woman immediately after a laparoscopic Nissen fundoplication procedure. This was diagnosed by echocardiography and treated successfully with percutaneous device closure. An intracardiac shunt should always be considered as a potential cause of refractory postoperative hypoxemia after procedures on the thorax and upper abdomen.

      Résumé

      L’hypoxémie postopératoire peut résulter de causes diverses. Nous décrivons un cas de platypnée-orthodéoxie causée par le shunt à travers un foramen ovale perméable chez une femme de 72 ans immédiatement après une fundoplicature de Nissen par laparoscopie. Le diagnostic a été posé par échocardiographie et suivi du traitement utilisant le dispositif de fermeture par voie percutanée. Un shunt intracardiaque devrait toujours être considéré comme une cause potentielle d’hypoxémie réfractaire après les interventions chirurgicales au thorax et à la partie supérieure de l’abdomen.
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