• J Formos Med Assoc · May 2006

    Case Reports

    Detection of right to left shunt by transesophageal echocardiography in a patient with postoperative hypoxemia.

    • Yu-Ling Yeh, Chen-Kun Liu, Wen-Kuei Chang, Kwok-Hon Chan, Jihn-Yih Li, and Shen-Kou Tsai.
    • Department of Anesthesiology, Taipei Veterans General Hospital, Taiwan.
    • J Formos Med Assoc. 2006 May 1; 105 (5): 418421418-21.

    AbstractIntracardiac right to left shunt through a patent foramen ovale (PFO) may result in the development of hypoxemia after cardiac surgery. Cardiac tamponade and mechanical ventilation with high positive endexpiratory pressure are the most common factors responsible for enhancing intracardiac right to left shunt through a PFO. We report an 83-year-old woman with Stanford type A dissecting aneurysm who developed hypoxemia and paradoxical air embolism after reconstruction of ascending aorta and Bental's procedure. Transesophageal echocardiography (TEE) revealed right to left shunting via a PFO. Surgical closure of the PFO was done without delay. This case illustrates the role of TEE in prompt diagnosis of intracardiac right to left shunting through a PFO causing postoperative hypoxemia after cardiac surgery.

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