Key result
Surgical repair involving PFO closure and ascending aorta replacement dramatically increased percutaneous oxygen saturation from 72% to 97% in the sitting position.
Case Report (n=1)
Absolute Event Rate: 97% vs 72%
Surgical intervention with PFO closure and ascending aortic replacement is an effective treatment option for platypnea-orthodeoxia syndrome caused by cardiac and aortic comorbidities in older patients.
May support surgical repair for platypnea-orthodeoxia with PFO and aortic pathology; hypothesis-generating from single case, needs prospective confirmation.
BACKGROUND: Platypnea-orthodeoxia syndrome (POS) is a relatively uncommon clinical syndrome characterized by dyspnea and deoxygenation accompanying postural changes, such as sitting or standing from a recumbent position. CASE PRESENTATION: We describe the case of a 76-year-old woman who was hospitalized with dyspnea in the sitting position, which was relieved in the right lateral decubitus position. The patient was diagnosed with POS caused by a patent foramen ovale (PFO), dilation and elongation of the ascending aorta, and pectus excavatum. We performed PFO closure and replacement of the ascending aorta via median sternotomy. The patient's postoperative percutaneous oxygen saturation dramatically increased in the sitting position. CONCLUSIONS: Elongated and dilated ascending aorta and pectus excavatum with PFO may be risk factors for POS. In older patients, surgical intervention is an important treatment option for POS caused by cardiac and aortic comorbidities.
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Wada et al. (2023) conducted a case report in Platypnea-orthodeoxia syndrome (n=1). PFO closure and replacement of the ascending aorta was evaluated on Percutaneous oxygen saturation in the sitting position. Surgical repair involving PFO closure and ascending aorta replacement dramatically increased percutaneous oxygen saturation from 72% to 97% in the sitting position.
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