Refractory Hypoxemia After Laparoscopic Nissen Fundoplication.
Postoperative hypoxemia can result from a variety of causes. We describe a case of platypnea-orthodeoxia caused by shunting across a patent foramen ovale in a 72-year-old woman immediately after a laparoscopic Nissen fundoplication procedure. This was diagnosed by echocardiography and treated successfully with percutaneous device closure. An intracardiac shunt should always be considered as a potential cause of refractory postoperative hypoxemia after procedures on the thorax and upper abdomen.
Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas. Electronic address: ymrochlani@uams.edu.
Yogita
Y
Rochlani
Division of Cardiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Srikanth
S
Vallurupalli
Division of Cardiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Abdul
A
Hakeem
Division of Cardiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Sabha
S
Bhatti
D000368:Aged; D006348:Cardiac Surgical Procedures / Q000379:methods; D004452:Echocardiography; D005260:Female; D054092:Foramen Ovale, Patent / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D018662:Fundoplication / Q000009:adverse effects*; D005764:Gastroesophageal Reflux / Q000150:complications / Q000601:surgery; D006551:Hernia, Hiatal / Q000150:complications / Q000601:surgery; D006801:Humans; D000860:Hypoxia / Q000175:diagnosis / Q000209:etiology*; D010535:Laparoscopy / Q000009:adverse effects*; D011183:Postoperative Complications