Platypnea Orthodeoxia Syndrome Secondary to Intracardiac Shunt Following Orthotopic Liver Transplantation

Platypnea Orthodeoxia Syndrome Secondary to Intracardiac Shunt Following Orthotopic Liver Transplantation

Platypnea orthodeoxia syndrome (POS) occurs when an upright position results in acute-onset hypoxemia and is relieved with recumbency. POS can be due to intracardiac shunting, intrapulmonary shunting, ventilation-perfusion mismatch, or a combination of these. We report a case of POS that developed 3...

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Main Authors: Sophia R. Larson MD, Philip Vutien MD, Zachary L. Steinberg MD
Format: Article
Language:English
Published: SAGE Publishing 2020-05-01
Series:Journal of Investigative Medicine High Impact Case Reports
Online Access:https://doi.org/10.1177/2324709620925575
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spelling doaj-dfca79e859d54cc4ba616f7403dafb962020-11-25T04:01:40ZengSAGE PublishingJournal of Investigative Medicine High Impact Case Reports2324-70962020-05-01810.1177/2324709620925575Platypnea Orthodeoxia Syndrome Secondary to Intracardiac Shunt Following Orthotopic Liver TransplantationSophia R. Larson MD0Philip Vutien MD1Zachary L. Steinberg MD2University of Washington, Seattle, WA, USAUniversity of Washington, Seattle, WA, USAUniversity of Washington, Seattle, WA, USAPlatypnea orthodeoxia syndrome (POS) occurs when an upright position results in acute-onset hypoxemia and is relieved with recumbency. POS can be due to intracardiac shunting, intrapulmonary shunting, ventilation-perfusion mismatch, or a combination of these. We report a case of POS that developed 3 days post liver transplantation as a result of new-onset right to left shunting across a patent foramen ovale. Right heart catheterization revealed a posteriorly directed inferior vena cava likely due to altered inferior vena cava—right atrial junction anatomy as a result of liver transplantation. The patient underwent successful transcatheter patent foramen ovale closure with a 25-mm Gore Cardioform septal occluder device with immediate and sustained improvement in hypoxia.https://doi.org/10.1177/2324709620925575
collection DOAJ
language English
format Article
sources DOAJ
author Sophia R. Larson MD
Philip Vutien MD
Zachary L. Steinberg MD
spellingShingle Sophia R. Larson MD
Philip Vutien MD
Zachary L. Steinberg MD
Platypnea Orthodeoxia Syndrome Secondary to Intracardiac Shunt Following Orthotopic Liver Transplantation
Journal of Investigative Medicine High Impact Case Reports
author_facet Sophia R. Larson MD
Philip Vutien MD
Zachary L. Steinberg MD
author_sort Sophia R. Larson MD
title Platypnea Orthodeoxia Syndrome Secondary to Intracardiac Shunt Following Orthotopic Liver Transplantation
title_short Platypnea Orthodeoxia Syndrome Secondary to Intracardiac Shunt Following Orthotopic Liver Transplantation
title_full Platypnea Orthodeoxia Syndrome Secondary to Intracardiac Shunt Following Orthotopic Liver Transplantation
title_fullStr Platypnea Orthodeoxia Syndrome Secondary to Intracardiac Shunt Following Orthotopic Liver Transplantation
title_full_unstemmed Platypnea Orthodeoxia Syndrome Secondary to Intracardiac Shunt Following Orthotopic Liver Transplantation
title_sort platypnea orthodeoxia syndrome secondary to intracardiac shunt following orthotopic liver transplantation
publisher SAGE Publishing
series Journal of Investigative Medicine High Impact Case Reports
issn 2324-7096
publishDate 2020-05-01
description Platypnea orthodeoxia syndrome (POS) occurs when an upright position results in acute-onset hypoxemia and is relieved with recumbency. POS can be due to intracardiac shunting, intrapulmonary shunting, ventilation-perfusion mismatch, or a combination of these. We report a case of POS that developed 3 days post liver transplantation as a result of new-onset right to left shunting across a patent foramen ovale. Right heart catheterization revealed a posteriorly directed inferior vena cava likely due to altered inferior vena cava—right atrial junction anatomy as a result of liver transplantation. The patient underwent successful transcatheter patent foramen ovale closure with a 25-mm Gore Cardioform septal occluder device with immediate and sustained improvement in hypoxia.
url https://doi.org/10.1177/2324709620925575
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AT philipvutienmd platypneaorthodeoxiasyndromesecondarytointracardiacshuntfollowingorthotopiclivertransplantation
AT zacharylsteinbergmd platypneaorthodeoxiasyndromesecondarytointracardiacshuntfollowingorthotopiclivertransplantation
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