Yeh Yu-Ling, Liu Chen-Kun, Chang Wen-Kuei, Chan Kwok-Hon, Li Jihn-Yih, Tsai Shen-Kou
Department of Anesthesiology, Taipei Veterans General Hospital, Taiwan.
J Formos Med Assoc. 2006 May;105(5):418-21. doi: 10.1016/S0929-6646(09)60139-X.
Intracardiac right to left shunt through a patent foramen ovale (PFO) may result in the development of hypoxemia after cardiac surgery. Cardiac tamponade and mechanical ventilation with high positive endexpiratory pressure are the most common factors responsible for enhancing intracardiac right to left shunt through a PFO. We report an 83-year-old woman with Stanford type A dissecting aneurysm who developed hypoxemia and paradoxical air embolism after reconstruction of ascending aorta and Bental's procedure. Transesophageal echocardiography (TEE) revealed right to left shunting via a PFO. Surgical closure of the PFO was done without delay. This case illustrates the role of TEE in prompt diagnosis of intracardiac right to left shunting through a PFO causing postoperative hypoxemia after cardiac surgery.
经未闭卵圆孔（PFO）的心脏内右向左分流可能导致心脏手术后低氧血症的发生。心脏压塞和高呼气末正压机械通气是导致经PFO的心脏内右向左分流增加的最常见因素。我们报告一例83岁的斯坦福A型主动脉夹层动脉瘤女性患者，在升主动脉重建和Bental手术后出现低氧血症和反常空气栓塞。经食管超声心动图（TEE）显示通过PFO存在右向左分流。立即对PFO进行了手术闭合。该病例说明了TEE在心脏手术后经PFO导致术后低氧血症的心脏内右向左分流的快速诊断中的作用。
