After open repair of a contained rupture of a giant abdominal aortic aneurysm, the patient, a 67-year-old man, developed respiratory insufficiency, and his hemoglobin oxygen saturation dramatically decreased when his position was changed from supine to upright. Transesophageal echocardiography revealed platypnea-orthodeoxia syndrome due to a patent foramen ovale and subsequent right-to-left-shunting despite normal intracardiac pressures. After interventional patent foramen ovale closure, the patient could be separated from the respirator without difficulty.
From the Departments of *Anesthesiology, and †Cardiothoracic and Vascular Surgery, Division of Vascular Surgery, Ulm University, Ulm, Germany.
Accepted for publication June 28, 2013.
Funding: Not funded.
The authors declare no conflicts of interest.
Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site.
Address correspondence to Sebastian Hafner, MD, Department of Anesthesiology, Ulm University, Albert-Einstein-Allee 23, D-89081 Ulm, Germany. E-mail address to firstname.lastname@example.org.