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.
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Address correspondence to Sebastian Hafner, MD, Department of Anesthesiology, Ulm University, Albert-Einstein-Allee 23, D-89081 Ulm, Germany. E-mail address to email@example.com.