Ghamande S, Ramsey R, Rhodes J F, Stoller J K
Department of Pulmonary and Critical Care Medicine, the Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
Chest. 2001 Dec;120(6):2094-6. doi: 10.1378/chest.120.6.2094.
A right-to-left shunt (RLS) is an uncommon complication of a patent foramen ovale (PFO) that may cause hypoxemia from venous admixture and ischemic complications from paradoxic embolization. This report presents the third described patient whose RLS through a PFO and profound hypoxemia developed in association with right hemidiaphragm dysfunction (but without a pressure gradient driving the right-to-left flow). In addition to extending the available experience with this unusual clinical event, we report on the successful closure of the PFO by a catheter-deployed double-umbrella device, after the positioning of which the patient's oxygenation normalized.
