Hypoxemia 4 month after right-sided pneumonectomy

A 64-year-old male reported worsening dyspnea four months after right-sided pneumonectomy, due to lung cancer. Platypneu-or-thodeoxie syndrome was suspected due to a decrease in oxygen-saturation while the patient was in upright position. The shift of the right hemidiaphragm and liver caused compres...

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Published inDer Internist (Berlin) Vol. 52; no. 8; pp. 1002 - 1005
Main Authors Mühling, O, Koller, M, Langbein, A, Fröhner, S, Schumacher, B, Kerber, S
Format Journal Article
LanguageGerman
Published Germany 01.08.2011
Subjects
Carcinoma, Bronchogenic - surgery
Cardiac Catheterization
Diagnosis, Differential
Echocardiography, Doppler
Echocardiography, Transesophageal
Foramen Ovale, Patent - diagnosis
Foramen Ovale, Patent - etiology
Foramen Ovale, Patent - surgery
Humans
Hypoxia - etiology
Lung Neoplasms - surgery
Male
Middle Aged
Pneumonectomy
Postoperative Complications - diagnosis
Postoperative Complications - etiology
Postoperative Complications - surgery
Recurrence
Reoperation
Sensitivity and Specificity
Tomography, X-Ray Computed
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Summary:A 64-year-old male reported worsening dyspnea four months after right-sided pneumonectomy, due to lung cancer. Platypneu-or-thodeoxie syndrome was suspected due to a decrease in oxygen-saturation while the patient was in upright position. The shift of the right hemidiaphragm and liver caused compression of the right atrium and a shunt over a persistent foramen ovale. The right-to-left shunt was proven during right heart catheter. Interventional closure of the shunt resulted in immediate improvement of arterial oxygenation and a decrease in dyspnea.
Bibliography:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
ObjectType-Feature-4
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ObjectType-Report-1
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ISSN:1432-1289
DOI:10.1007/s00108-010-2744-9