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Titolo:
RIGHT-TO-LEFT INTERATRIAL SHUNT AFTER PNEUMONECTOMY
Autore:
BAKRIS NC; SIDDIQI AJ; FRASER CD; MEHTA AC;
Indirizzi:
CLEVELAND CLIN FDN,DEPT PULM & CRIT CARE MED,1 CLIN CTR CLEVELAND OH 44195 CLEVELAND CLIN FDN,DEPT PULM & CRIT CARE MED CLEVELAND OH 44195 CLEVELAND CLIN FDN,DEPT INTERNAL MED CLEVELAND OH 44195 CLEVELAND CLIN FDN,DEPT CARDIOTHORAC SURG CLEVELAND OH 44195
Titolo Testata:
The Annals of thoracic surgery
fascicolo: 1, volume: 63, anno: 1997,
pagine: 198 - 201
SICI:
0003-4975(1997)63:1<198:RISAP>2.0.ZU;2-7
Fonte:
ISI
Lingua:
ENG
Soggetto:
PLATYPNEA; HYPOXEMIA; LOBECTOMY; DYSPNEA;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
14
Recensione:
Indirizzi per estratti:
Citazione:
N.C. Bakris et al., "RIGHT-TO-LEFT INTERATRIAL SHUNT AFTER PNEUMONECTOMY", The Annals of thoracic surgery, 63(1), 1997, pp. 198-201

Abstract

Background. Platypnea and Orthodeoxia have been described with congenital heart and severe lung diseases. Methods. We report 4 patients in whom platypnea and orthodeoxia developed after pneumonectomy. In thesepatients the mean oxygen saturation on room air was 65% (range, 45% to 79%) in the supine position. On O-2 therapy it improved to 94% (range, 80% to 99%). When the patients assumed the erect position and were receiving O-2 therapy the saturation dropped to a mean of 76% (range, 56% to 82%) and the patients complained of shortness of breath. Cardiac catheterization revealed a mean pulmonary capillary wedge pressure of 11.6 mm Hg (range, 7 to 18 mm Hg). All patients had normal right atrial pressure. A right-to-left interatrial shunt through a patent foramen ovale was documented by transesophageal echocardiography and dynamic ultrafast magnetic resonance imaging. The patients underwent surgical closure of the patent foramen ovale. Results. In the erect position,the room air O-2 saturation improved to a mean of 95% (range, 92% to 99%), and the shortness of breath disappeared. Conclusions. Postpneumonectomy patients complaining of shortness of breath should be assessedfor platypnea and orthodeoxia. A right-to-left interatrial shunt through a patent foramen ovale can occur even in the absence of elevated right heart pressures, especially after right pneumonectomy, and is accentuated in the upright posture. Surgical correction of the patent foramen ovale can produce dramatic improvement. (C) 1997 by The Society of Thoracic Surgeons

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 13/08/20 alle ore 05:45:55