title: Hemidiaphragmatic paralysis: an underestimated etiology of right-to-left shunt through patent foramen ovale?
abstract: OBJECTIVE
  To report a specific pathophysiology of hemidiaphragmatic paralysis that may result in severe hypoxemia.
  
  
  METHODS
  Case series.
  
  
  METHODS
  Intensive care unit in a cardiology hospital.
  
  
  METHODS
  The series included three patients with refractory hypoxemia in whom a diagnosis of right-to-left-shunt through a patent foramen ovale was made by contrast echocardiography. The three patients had a complete right hemidiaphragmatic paralysis.
  
  
  METHODS
  Permanent percutaneous closure of the patent foramen ovale was successfully proceeded in all cases.
  
  
  RESULTS
  These procedures resulted in complete normalization of arterial oxygen saturation.
  
  
  CONCLUSIONS
  To our knowledge, only three previous reports have described the association of right-to-left shunt through a patent foramen ovale and hemidiaphragmatic paralysis. Such association may be underestimated.
authors.affiliation: Intensive Care Unit, Cardiology Hospital, Bd Pr J Leclercq, 59000 Lille, France.
authors.forename: Julie S
authors.initials: JS
authors.lastname: Darchis
authors.forename: Pierre V
authors.initials: PV
authors.lastname: Ennezat
authors.forename: Clément
authors.initials: C
authors.lastname: Charbonnel
authors.forename: Jean Marc
authors.initials: JM
authors.lastname: Aubert
authors.forename: Xavier
authors.initials: X
authors.lastname: Gonin
authors.forename: Jean Luc
authors.initials: JL
authors.lastname: Auffray
authors.forename: Jean Jacques
authors.initials: JJ
authors.lastname: Bauchart
authors.forename: Thierry
authors.initials: T
authors.lastname: Le Tourneau
authors.forename: Christian
authors.initials: C
authors.lastname: Rey
authors.forename: François
authors.initials: F
authors.lastname: Godart
authors.forename: Patrick
authors.initials: P
authors.lastname: Goldstein
authors.forename: Philippe
authors.initials: P
authors.lastname: Asseman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003326:Coronary Circulation; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D000860:Hypoxia / Q000209:etiology* / Q000503:physiopathology; D008875:Middle Aged; D012133:Respiratory Paralysis / Q000150:complications* / Q000503:physiopathology