Pernigo Matteo, Canneto Barbara, Betta Davide, Molinari Gionata, Ribichini Flavio, Zannini Guido, Vassanelli Corrado, Rossi Andrea
Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy.
Division of Thoracic Surgery, AOUI Verona, Verona, Italy.
Echocardiography. 2017 May;34(5):782-785. doi: 10.1111/echo.13505. Epub 2017 Mar 14.
Dyspnea and hypoxemia are common postoperative problems after pneumonectomy. One of the rarer causes of respiratory distress after right pneumonectomy is the development of a significant right-to-left shunt across a patent foramen ovale (PFO), which can evolve at a variable interval of time after the operation. We report here our experience with a patient who underwent right pneumonectomy, followed by several complications, and who presented severe dyspnea 7 months later, after the closure of a right thoracostomy. This report outlines the management of this challenging clinical condition; transesophageal echocardiography (TOE) provided a clear diagnosis and guided an effective percutaneous treatment.
呼吸困难和低氧血症是肺切除术后常见的术后问题。右肺切除术后呼吸窘迫较罕见的原因之一是经未闭卵圆孔（PFO）出现显著的右向左分流，这种情况可在术后不同时间间隔出现。我们在此报告一例接受右肺切除术的患者的情况，该患者术后出现多种并发症，并在右胸造口关闭7个月后出现严重呼吸困难。本报告概述了对这种具有挑战性的临床状况的处理；经食管超声心动图（TOE）提供了明确诊断并指导了有效的经皮治疗。
