Hemidiaphragmatic paralysis: an underestimated etiology of right-to-left shunt through patent foramen ovale?
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.
Darchis
Julie S
JS
Intensive Care Unit, Cardiology Hospital, Bd Pr J Leclercq, 59000 Lille, France.
Ennezat
Pierre V
PV
Charbonnel
Clément
C
Aubert
Jean Marc
JM
Gonin
Xavier
X
Auffray
Jean Luc
JL
Bauchart
Jean Jacques
JJ
Le Tourneau
Thierry
T
Rey
Christian
C
Godart
François
F
Goldstein
Patrick
P
Asseman
Philippe
P
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