Journal
TEXAS HEART INSTITUTE JOURNAL
Volume 50, Issue 5, Pages -Publisher
TEXAS HEART INST
DOI: 10.14503/THIJ-23-8229
Keywords
Foramen ovale; patent; lung transplantation; hypoxia; pulmonary fibrosis
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This case describes a patient with interstitial pulmonary fibrosis who remained hypoxemic after bilateral lung transplant, and immediate improvement in oxygenation was achieved after surgical repair of a patent foramen ovale.
A 64-year-old man with interstitial pulmonary fibrosis and a small patent foramen ovale with right-to-left shunting underwent bilateral lung transplant without closure of the patent foramen ovale. Postoperatively, the patient remained persistently hypoxemic with partial response to high-flow oxygen. Investigations revealed the presence of a large patent foramen ovale with right-to- left shunting on echocardiography and a shunt fraction of 21% on cardiac catheterization. Two months after the lung transplantation, primary surgical repair of the patent foramen ovale was performed with immediate improvement in oxygenation. Three years postoperatively, the patient remained oxygen independent.
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