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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References
- Haemodynamic complications after pneumonectomy: atrial inflow obstruction and reopening of the foramen ovale.Eur J Cardiothorac Surg. 2008; 33: 268-271
- A change of heart: reopening of a foramen ovale.Can J Cardiol. 2014; 30: 1250.e17-1250.e18
- Nitric oxide therapy for post-laparoscopic surgery associated patent foramen ovale: incidence, mechanisms, diagnosis and therapy.Heart Lung. 2014; 43: 155-157
- Patent foramen ovale with platypnea-orthodeoxia due to colonic distention.Consultant. 2015; 55: 131-132
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Article info
Publication history
Published online: July 02, 2015
Accepted:
June 25,
2015
Received:
May 6,
2015
Footnotes
See editorial by Butt, pages 294-295 of this issue.
See page 395.e2 for disclosure information.
Identification
Copyright
© 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
