Diagnostic Pitfall of Platypnea-Orthodeoxia Syndrome Caused by Atrial Septal Defect after Right Pneumonectomy

Y Bohren; M Lopez; N Santelmo; J Ristorto; P Billaud; M Canuet; P M Mertes; O Collange

doi:10.1155/2020/4257185

Diagnostic Pitfall of Platypnea-Orthodeoxia Syndrome Caused by Atrial Septal Defect after Right Pneumonectomy

Case Rep Crit Care. 2020 Feb 20:2020:4257185. doi: 10.1155/2020/4257185. eCollection 2020.

Authors

Y Bohren¹, M Lopez¹, N Santelmo², J Ristorto³, P Billaud⁴, M Canuet⁵, P M Mertes¹, O Collange¹

Affiliations

¹ Department of Anaesthesiology and Intensive Care, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
² Department of Thoracic Surgery, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
³ Department of Cardiology, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
⁴ Department of Cardiac Surgery, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
⁵ Department of Pulmonology, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.

Abstract

We describe a case of platypnea-orthodeoxia syndrome (POS) due to atrial septal defect (ASD) occurring in the early postoperative course of a right pneumonectomy. Deformation of the atrial septum after right pneumonectomy deviates the blood from the inferior vena cava to ASD during the sitting position creating, a massive right-to-left shunt. Diagnosis can initially be missed by making contrast bubble test through the superior vena cava. The atrial septal defect was then closed using the surgical technique, allowing an instantaneous improvement of hematosis.

Publication types

Case Reports