scholarly journals Platypnea-orthodeoxia syndrome after open prostatectomy and cystolithotomy: Coincidence or unknown pathophysiology?

2020 ◽  
Vol 8 ◽  
pp. 2050313X2090459
Author(s):  
Ismael P Flores ◽  
Alexandre T Maciel
Keyword(s):  
Case Report ◽  
Patent Foramen Ovale ◽  
Inferior Vena ◽  
Vena Cava ◽  
Sitting Position ◽  
Foramen Ovale ◽  
Open Prostatectomy ◽  
Anatomical Changes ◽  
Upper Abdominal ◽  
Cardiac Shunt

A few cases of platypnea-orthodeoxia syndrome have been described in the literature, some of them after thoracic or upper abdominal surgeries. In most cases, hypoxemia in the upright or sitting position, which is the main clinical symptom for this uncommon diagnosis, is usually related to a dynamic right to left cardiac shunt induced by anatomical changes in the relative position between the inferior vena cava and the atria in the presence of a patent foramen ovale. In this case report, we describe a situation in which platypnea-orthodeoxia syndrome developed acutely before surgery but that became severely exacerbated after an open urologic surgery without a clear acute anatomical change that could be responsible for triggering the syndrome. This case might suggest that the pathophysiology of acute platypnea-orthodeoxia syndrome is not completely elucidated and that other possible triggers for acute clinical manifestation in addition to acute anatomical thoracic changes must be explored.

scholarly journals Unplanned Removal of a Patent Foramen Ovale Closure Device During Retrieval of an Inferior Vena Cava Filter

2021 ◽  
Author(s):  
Marc Agzarian ◽  
Ajay Sinhal
Keyword(s):  
Case Report ◽  
Inferior Vena Cava ◽  
Patent Foramen Ovale ◽  
Inferior Vena Cava Filter ◽  
Inferior Vena ◽  
Vena Cava ◽  
Vena Cava Filter ◽  
Closure Device ◽  
Foramen Ovale ◽  
First Case

Abstract This brief communication reports what appears to be the first case of an interaction between an inferior vena cava filter and a patent foramen ovale closure device. During removal of the inferior vena cava filter, the patent foramen ovale closure device was unintentionally removed. This case report serves to highlight the possible interaction of these two devices.

scholarly journals Patent foramen ovale closure in a patient with vena cava filter: a case report

2021 ◽  
Vol 5 (7) ◽  
Author(s):  
Pierluigi Omedè ◽  
Pier Paolo Bocchino ◽  
Ovidio De Filippo ◽  
Fabrizio D’Ascenzo
Keyword(s):  
Inferior Vena Cava ◽  
Patent Foramen Ovale ◽  
Interventional Procedures ◽  
Inferior Vena ◽  
Vena Cava ◽  
Delivery Systems ◽  
Foramen Ovale ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
Pfo Closure

Abstract Background The presence of a patent foramen ovale (PFO) is associated with several medical conditions, including cryptogenic left circulation thromboembolism. PFO closure was demonstrated to reduce recurrent ischaemic stroke in patients with prior cryptogenic stroke. The presence of an inferior vena cava filter (IVCF), however, may impede a transfemoral PFO closure procedure. Case summary We describe the case of a 50-year-old man with a PFO suffering from ischaemic stroke from paradoxical thromboembolism originating from deep vein thrombosis and requiring an IVCF. After deep vein thrombosis resolution, due to the high risk of stroke recurrences, the patient was recommended PFO closure. IVCF retrieval by the interventional radiologist was first attempted but failed. A transfemoral PFO closure procedure was thus endeavoured with the IVCF in place and was successful. The patient was then discharged in good clinical status and no stroke recurrences were reported at 5 months follow-up. Discussion Albeit an IVCF provides benefit in patients with recurrent thromboembolic events despite adequate anticoagulation therapy, its presence may hinder interventional procedures necessitating delivery systems to advance through the inferior vena cava. We reported on a successful PFO closure procedure via a femoral venous access in a patient with an IVCF in place, thus demonstrating the feasibility of advancing delivery systems through an IVCF. As interventional procedures requiring the advancement of delivery systems through the inferior vena cava are becoming increasingly common, the feasibility of IVCF crossing with catheters and delivery systems alike paves the way for novel interventional possibilities.

scholarly journals Platypnea Orthodeoxia Syndrome Secondary to Intracardiac Shunt Following Orthotopic Liver Transplantation

2020 ◽  
Vol 8 ◽  
pp. 232470962092557
Author(s):  
Sophia R. Larson ◽  
Philip Vutien ◽  
Zachary L. Steinberg
Keyword(s):  
Liver Transplantation ◽  
Inferior Vena Cava ◽  
Patent Foramen Ovale ◽  
Inferior Vena ◽  
Vena Cava ◽  
Acute Onset ◽  
Right Atrial ◽  
Heart Catheterization ◽  
Foramen Ovale ◽  
Septal Occluder Device

Platypnea orthodeoxia syndrome (POS) occurs when an upright position results in acute-onset hypoxemia and is relieved with recumbency. POS can be due to intracardiac shunting, intrapulmonary shunting, ventilation-perfusion mismatch, or a combination of these. We report a case of POS that developed 3 days post liver transplantation as a result of new-onset right to left shunting across a patent foramen ovale. Right heart catheterization revealed a posteriorly directed inferior vena cava likely due to altered inferior vena cava—right atrial junction anatomy as a result of liver transplantation. The patient underwent successful transcatheter patent foramen ovale closure with a 25-mm Gore Cardioform septal occluder device with immediate and sustained improvement in hypoxia.

Inferior Vena Cava Compression as a Novel Maneuver to Detect Patent Foramen Ovale: A Transesophageal Echocardiographic Study

2017 ◽  
Vol 30 (3) ◽  
pp. 292-299 ◽  
Author(s):  
Eiji Yamashita ◽  
Tomoyuki Murata ◽  
Eri Goto ◽  
Takeshi Fujiwara ◽  
Takehito Sasaki ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Patent Foramen Ovale ◽  
Inferior Vena ◽  
Vena Cava ◽  
Foramen Ovale ◽  
Echocardiographic Study

scholarly journals Postnatal Amelioration of Fetal Right Ventricular Hypoplasia Associated with Large Eustachian Valve: A Case Report

2019 ◽  
Vol 09 (04) ◽  
pp. e357-e360
Author(s):  
Ayaka Iwatani ◽  
Fumihito Miyake ◽  
Hirotaka Ishido ◽  
Masayo Kanai ◽  
Akio Ishiguro ◽  
...  
Keyword(s):  
Case Report ◽  
Inferior Vena Cava ◽  
Right Ventricle ◽  
Right Ventricular ◽  
Inferior Vena ◽  
Vena Cava ◽  
Foramen Ovale ◽  
Eustachian Valve ◽  
Respiratory Management ◽  
The Right

AbstractIn fetuses, the Eustachian valve directs oxygenated blood returning from the inferior vena cava into the left atrium via the foramen ovale. If too large, the Eustachian valve can restrict right ventricular inflow, as well as induce postnatal cyanosis via an interatrial right-to-left shunt. We report a fetal case of postnatal amelioration of the tricuspid valve and right ventricle hypoplasia, despite significant right ventricular hypoplasia associated with a large Eustachian valve. Application of an appropriate respiratory management regimen to help reduce pulmonary vascular resistance is of particular importance for the reversal of the right-to-left shunt via the foramen ovale and associated increases in right ventricular inflow.

scholarly journals Platypnea–orthodeoxia syndrome associated with COVID-19 pneumonia: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Takuo Hoshi ◽  
Yu Tadokoro ◽  
Masaru Nemoto ◽  
Junya Honda ◽  
Shihori Matsukura
Keyword(s):  
Case Report ◽  
Patent Foramen Ovale ◽  
Oxygen Therapy ◽  
Upright Position ◽  
Sitting Position ◽  
Foramen Ovale ◽  
Recumbent Position ◽  
Gradual Improvement ◽  
Case Presentation ◽  
Intracardiac Shunt

Abstract Background Platypnea–orthodeoxia syndrome (POS) is a rare clinical condition characterized by respiratory distress and/or hypoxia developing in the sitting/upright position, which is relieved in the recumbent position. This syndrome is known to have an intracardiac shunt as its primary etiology. Here, we report the case of a patient who was found to have POS without an intracardiac shunt while recovering from coronavirus disease (COVID-19) pneumonia. Case presentation A 73-year-old woman was diagnosed with severe COVID-19 pneumonia and was managed according to our institutional protocol. Although her oxygenation improved at rest, oxygen saturation dropped to lower than 80% when she was in the sitting position. She had no patent foramen ovale or other intracardiac shunts. She showed gradual improvement and was discharged under home oxygen therapy 28 days after admission. Conclusions This report highlights the importance of continuous bedside monitoring of pulse oximetry during positional changes, even if it is stable at rest, in patients with moderate to severe COVID-19.

scholarly journals Treatment for Leiomyosarcoma of the Inferior Vena Cava Complicated with Lung Adenocarcinoma: A Case Report and Literature Review

2021 ◽  
Author(s):  
Xiaohu Guo ◽  
Xiaoyan Liu ◽  
Zhengang Wei ◽  
Mancai Wang ◽  
Youcheng Zhang
Keyword(s):  
Case Report ◽  
Inferior Vena Cava ◽  
Lung Adenocarcinoma ◽  
Inferior Vena ◽  
Left Lung ◽  
Vena Cava ◽  
Perioperative Period ◽  
Lung Lobe ◽  
Rare Malignancy ◽  
Upper Abdominal

Abstract Background: Leiomyosarcoma originating from the inferior vena cava (IVC) is a very rare malignancy. We searched the databases and did not find similar cases of leiomyosarcoma of the IVC with lung adenocarcinoma. Here, we report a patient with IVC leiomyosarcoma and lung adenocarcinoma.Case report: The patient, a 38-year-old Chinese female, presented to the general department with a history of intermittent right upper abdominal pain for 18 months. Contrast-enhanced computed tomography (CT) showed a tumour of IVC (3.4*2.7 cm) extending to the renal veins. In addition, chest CT showed a tumour in the left lung lobe. Then, the patient underwent surgery to resect the IVC tumour and partial lung. The patient received Gefitinib Tablets treatment 250 mg per day for 18 months during the perioperative period. The examination of the patient showed lung recurrence at the 18th month after partial pneumonectomy. So the patient again received thoracoscopic wedge pneumonectomy, and it was confirmed to be metastasis of IVC tumour. The patient received daily 12 mg treatment with Anlotinib after the last operation. Regular outpatient follow-up showed that there was no obvious recurrence and metastasis as of April 2021 (6 months after operation).Conclusions: It is difficult to diagnose and treat patients with IVC leiomyosarcoma and lung adenocarcinoma in a timely manner. Surgery is still an effective treatment for patients with IVC leiomyosarcoma and lung adenocarcinoma at present.

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