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Platypnea-Orthodeoxia: A Rare Complication After Repair of a Contained Rupture of an Abdominal Aortic Aneurysm

Hafner, Sebastian MD*; Scheerer, Nico MD*; Stahl, Wolfgang MD*; Muehling, Bernd MD, PhD; Georgieff, Michael MD, PhD*; Bracht, Hendrik MD, PhD*; Wepler, Martin MD*

doi: 10.1097/ACC.0b013e3182a5c4d3
Case Reports: Case Report

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 sebastian.hafner@uniklinik-ulm.de.

© 2014 International Anesthesia Research Society
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