Publish in this journal
Journal Information
Vol. 72. Issue 10.
Pages 865 (October 2019)
Image in cardiology
DOI: 10.1016/j.rec.2018.07.022
Full text access
PFO With Platypnea-orthodeoxia in the Absence of Inferior Cava
FOP con platipnea-ortodesoxia y ausencia de cava inferior
Visits
...
Javier Suárez de Lezo
Corresponding author
jslht@yahoo.es

Corresponding author:
, José María Segura, José Suárez de Lezo
Grupo Cardiológico CORPAL, Hospital Cruz Roja de Córdoba, Córdoba, España
This item has received
...
Visits
(Daily data update)
Article information
Full Text
Download PDF
Statistics
Figures (2)
Full Text

A 78-year-old woman was diagnosed with platypnea-orthodeoxia syndrome caused by patent foramen ovale (PFO) with right-left flow and orthostatic desaturation (78%). PFO closure was scheduled. During the procedure, the inferior vena cava was found to be missing and a large azygos vein was present that drained into the superior vena cava (Figure 1A). The contrast administered entered the left atrium through a tunneled PFO (Figure 1B). This anatomical feature complicated the procedure, and it was necessary to pass a JL4 guide catheter through the PFO and, using this catheter, place a coronary guidewire in the pulmonary vein (Figure 2A). Subsequently, with the help of a daughter catheter, a balloon was placed in the pulmonary vein, thus allowing an anchoring maneuver (Figure 2B). This enabled advancement of the guide catheter followed by introduction of a stiff guidewire into the left atrium, thereby allowing cannula advancement (Figure 2C). An Amplatzer 25mm device was introduced via the cannula, and the first the left disc (Figure 2D) and then the right disc (Figure 2E) were deployed. After full deployment, contrast no longer passed from the left atrium (Figure 2F).

Figure 1
(0.16MB).
Figure 2
(0.19MB).

The scientific literature has few reports of PFO closure in the absence of inferior vena cava and, to the best of our knowledge, this is the first case with concurrent platypnea-orthodeoxia syndrome. Closure in such conditions is feasible, although the technique is more difficult. An alternative approach in these cases could be via the jugular or transhepatic vein.

Copyright © 2018. Sociedad Española de Cardiología
Idiomas
Revista Española de Cardiología (English Edition)

Subscribe to our newsletter

Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

es en
Política de cookies Cookies policy
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.