Intraoperative hypoxemia and dynamic right-to-left shunting across a
patent foramen ovale diagnosed by TEE
Abstract
The images presented highlight the degree of dynamic right-to-left shunt
(RTLS) across a typical patent foramen ovale (PFO) that is possible with
suboptimal changes in ventilation and oxygenation that may occur under
anesthesia or in the intensive care setting. In this case, a large RTLS
across a PFO contributed to significant persistent hypoxemia, and the
echocardiography exam was necessary for diagnosis, aggressive treatment,
and complete resolution of the pathology.