Should we close hypoxaemic patent foramen ovale and interatrial shunts on a systematic basis?

Tahlawi, Mohammad El; Jop, Bertrand; Bonello, Béatrice; Dragulescu, Andréea; Rouault, F; Habib, Gilbert; Fraisse, Alain

doi:10.1016/j.acvd.2009.09.009

Cited by 18 publications

(13 citation statements)

References 11 publications

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“…post‐pneumoectomy, abdominal surgery or dilatation of the ascending aorta). Elevation in RA pressure relative to LA pressure will also cause right‐to‐left shunting across the interatrial defect and can occur in cardiac tamponade or conditions that increase right‐sided heart pressures (RV infarction, atresia or stenosis of the pulmonary or tricuspid valve and decrease diastolic compliance of the RV) . We have demonstrated that in our case, shunting occurred without pulmonary hypertension due to decreased diastolic compliance and increased pressures in the right heart (mean RA 10 mmHg, RV end‐diastolic pressure 10 mmHg), equalising the LA pressures (direct LA pressure 14 mmHg).…”

Section: Discussionmentioning

confidence: 63%

Normalisation of hypoxaemia following successful percutaneous closure of a bidirectional shunting secundum atrial septal defect without pulmonary hypertension in a patient with severe non‐ischaemic cardiomyopathy and refractory ventricular tachycardia

Anderson

Wilson

Morton

et al. 2016

Internal Medicine Journal

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Atrial septal defects (ASD) are an uncommon cause of dyspnoea. A high index of suspicion is required, and further investigation should be prompted in patients with unexplained hypoxaemia, particularly those with pulmonary hypertension. Hypoxic ASD without pulmonary hypertension are rare, and only a handful of cases have been published. We present a middle-aged man with progressive dyspnoea with a successfully closed ASD without pulmonary hypertension caused by elevated right ventricular pressures secondary to an idiopathic cardiomyopathy.

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Section: Discussionmentioning

confidence: 63%

Normalisation of hypoxaemia following successful percutaneous closure of a bidirectional shunting secundum atrial septal defect without pulmonary hypertension in a patient with severe non‐ischaemic cardiomyopathy and refractory ventricular tachycardia

Anderson

Wilson

Morton

et al. 2016

Internal Medicine Journal

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“…Currently, there are no clearly-defined guidelines with reference to PFO management due to the lack of randomised controlled trials comparing the different treatment options 3. There is even less evidence concerning the optimal management of patients with severe hypoxaemia from RLS due to reopening of an FO 9 20. Recent studies suggest that percutaneous closure is an effective treatment in hypoxemic shunts with functional improvement of the patients and resolution of acute respiratory failure 5.…”

Section: Discussionmentioning

confidence: 99%

Platypnea-orthodeoxia syndrome related to right hemidiaphragmatic elevation and a ‘stretched’ patent foramen ovale

Sakagianni

Evrenoglou

Mytas³

et al. 2012

BMJ Case Reports

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Patent foramen ovale (PFO), although frequently observed in adults, rarely causes adverse clinical consequences. The most serious among them, are cryptogenic strokes and less commonly significant hypoxia resulting from right-to-left shunt (RLS). Platypnea-orthodeoxia syndrome referring to abnormal oxygenation in the upright position has been correlated with reopening of foramen ovale and acute right-to-left intracardiac shunt. We report a case of platypnea-orthodeoxia syndrome secondary to the development of RLS through a 'stretched' PFO, in a patient admitted to the intensive care unit with severe respiratory failure requiring mechanical ventilation. The RLS was associated with right hemidiaphragmatic elevation, without an increased interatrial pressure gradient. The patient was successfully weaned from the ventilator after the percutaneous closure of PFO through a catheter-deployed double-umbrella device, presenting a full recovery.

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“…Several small molecule inhibitors and radiotherapy in the abdomen and lower extremities have been linked with accelerated progression of PAD, especially in those patients with underlying preexisting cardiovascular risk factors [55][56][57][58]. Nilotinib and ponatinib-two tyrosine kinase inhibitors used for the treatment of Philadelphia chromosome-positive chronic myelocytic leukemia-have been associated with rapidly progressive peripheral atherosclerosis, sometimes resulting in early termination of crucial therapy [58,59].…”

Section: Peripheral Artery Disease From Vasculotoxic Therapiesmentioning

confidence: 99%

Applications of Cardiac Computed Tomography in the Cardio-Oncology Population

Layoun

Yang

Herrmann

et al. 2019

Curr. Treat. Options in Oncol.

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Opinion statementThe increased risk for cardiovascular events in aging cancer survivors and those undergoing certain chemotherapeutic treatments has raised concern for more rigorous screening and surveillance methods above that of the general population. At this time, there are limited guidelines for how to best manage this vulnerable cohort. Questions regarding timing of screening, choice of imaging modality and risk reduction strategies-especially in those patients with known atherosclerotic disease-remain to be elucidated. Over a decade of case series, retrospective studies and clinical trials have shed light on the evolving role of cardiac computed tomography (CT) in this population, of which there is a relative paucity of data regarding its potential utility in the specific cardio-oncology population. Focusing on ability of cardiac CT to evaluate multiple cardiac and vascular structures, provide diagnostic and prognostic information, as well as assist interventional and surgical colleagues in surgical/percutaneous valve replacement and revascularization strategies is the premise for this review.

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Should we close hypoxaemic patent foramen ovale and interatrial shunts on a systematic basis?

Cited by 18 publications

References 11 publications

Normalisation of hypoxaemia following successful percutaneous closure of a bidirectional shunting secundum atrial septal defect without pulmonary hypertension in a patient with severe non‐ischaemic cardiomyopathy and refractory ventricular tachycardia

Normalisation of hypoxaemia following successful percutaneous closure of a bidirectional shunting secundum atrial septal defect without pulmonary hypertension in a patient with severe non‐ischaemic cardiomyopathy and refractory ventricular tachycardia

Platypnea-orthodeoxia syndrome related to right hemidiaphragmatic elevation and a ‘stretched’ patent foramen ovale

Applications of Cardiac Computed Tomography in the Cardio-Oncology Population

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