Hypoxemia-orthodeoxia related to patent foramen ovale without pulmonary hypertension

ObjectivePatent foramen ovale (PFO) is frequent but rarely associated with platypnea-orthodeoxia syndrome and with no pulmonary hypertension.Materials and MethodsWe performed a retrospective analysis of 12 consecutive patients with hypoxemia and PFO without increased pulmonary arterial pressure. The study was conducted at a single-center university hospital. We analyzed the patients' clinical records, gas exchange, contrast echocardiography studies, and survival.ResultsTwelve patients, aged 73.1 ± 9.5 years, were diagnosed with PFO between 1993 and 2005. All patients experienced dyspnea and/or hypoxemia. Six right hemidiaphragmatic elevations were observed on radiography. The shunt was apparent in three patients using transthoracic echocardiography and in all patients using transesophageal echocardiography. The mean follow-up was 27.6 ± 32.9 months. The PFO was closed in eight patients, six via percutaneous approach and two via surgery.ConclusionPFO may be patent and responsible for hypoxemia without pulmonary hypertension. This condition is easily recognized with transesophageal echocardiography, leading in most cases to a percutaneous closure resulting in a dramatic correction of hypoxemia.