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Patent Foramen Ovale-Related Hypoxemia After Bilateral Lung Transplant
Lekhya Raavi1, Pankaj Garg1, Mohammad Alomari1
1Department of Cardiothoracic Surgery, Mayo Clinic, Jacksonville, Florida.
Abstract:
A 64-year-old man with interstitial pulmonary fibrosis and a small patent foramen ovale with right-to-left shunting underwent bilateral lung transplant without closure of the patent foramen ovale. Postoperatively, the patient remained persistently hypoxemic with partial response to high-flow oxygen. Investigations revealed the presence of a large patent foramen ovale with right-to-left shunting on echocardiography and a shunt fraction of 21% on cardiac catheterization. Two months after the lung transplantation, primary surgical repair of the patent foramen ovale was performed with immediate improvement in oxygenation. Three years postoperatively, the patient remained oxygen independent.
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