title: Postoperative rescue closure of patent foramen ovale in the clinical setting of acute hypoxemic respiratory failure and stroke following coronary artery bypass surgery.
abstract: We describe a case of intraoperative diagnosis and successful deferred percutaneous closure of a patent foramen ovale (PFO) in the clinical setting of acute refractory hypoxemic respiratory failure and new-onset ischemic stroke in an elderly patient after coronary artery bypass graft. Perioperative morbidity (i.e. severe hypoxemia, worsening right ventricular dysfunction, and embolic stroke) that is potentially related to intraoperatively diagnosed PFO during cardiac surgery can complicate management in the Intensive Care Unit and perhaps affect the patient's outcome. Although the PFO closure can be challenging in the clinical setting of hypoxemic respiratory failure and stroke following cardiac surgery, it can be a reasonable perioperative option.
authors.affiliation: Department of Critical Care Medicine and Anesthesiology, Mayo Clinic, Jacksonville, Florida, USA.
authors.forename: Jos L
authors.initials: JL
authors.lastname: DIaz-Gómez
authors.forename: Eduardo
authors.initials: E
authors.lastname: Rodrigues
authors.forename: Monica
authors.initials: M
authors.lastname: Mordecai
authors.forename: John
authors.initials: J
authors.lastname: Moss
authors.forename: Richard C
authors.initials: RC
authors.lastname: Agnew
authors.forename: Keith R
authors.initials: KR
authors.lastname: Oken
mesh_terms: D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000209:etiology; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D017548:Echocardiography, Transesophageal; D017809:Fatal Outcome; D054092:Foramen Ovale, Patent / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D000860:Hypoxia / Q000150:complications / Q000628:therapy*; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000628:therapy*; D012131:Respiratory Insufficiency / Q000150:complications / Q000628:therapy*; D020521:Stroke / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*