Nitric oxide therapy for post-laparoscopic surgery associated patent foramen ovale: incidence, mechanisms, diagnosis and therapy.
OBJECTIVE
Postoperative hypoxemia is a common clinical challenge. The diagnosis of an underlying cause of hypoxemia may not immediately be apparent. Clinically silent and non-functional intracardiac shunt may become apparent and pose significant management problems in the postoperative period.


METHODS
We describe a case where clinically significant hypoxemia resulted from a patent foramen ovale (PFO) after laparoscopic surgery due to changes in the intra-abdominal and intrathoracic pressures.


CONCLUSIONS
This condition was effectively diagnosed by bedside echocardiography, and was effectively treated with nitric oxide.
Department of Critical Care Medicine, Mayo Clinic, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USA. Electronic address: helmers.richard@mayo.edu.
Richard A
RA
Helmers
Division of Cardiovascular Diseases, Mayo Clinic, Phoenix, AZ, USA.
Krishnaswamy
K
Chandrasekaran
D000280:Administration, Inhalation; D017548:Echocardiography, Transesophageal; D054092:Foramen Ovale, Patent / Q000150:complications / Q000000981:diagnostic imaging*; D018662:Fundoplication; D006801:Humans; D000860:Hypoxia / Q000209:etiology*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000627:therapeutic use*; D011183:Postoperative Complications
D009569:Nitric Oxide
Cardiac shunt; Echocardiography; Hypoxemia; Laparoscopy; Nitric oxide; PFO (patent foramen ovale)