• Thais Almeida Lins Pedersen, Signe Holm Larsen, and Jens Erik Nielsen-Kudsk.
• a Department of Research in Cardiothoracic and Vascular Surgery , Aarhus University Hospital , Aarhus N , Denmark.
• Scand. Cardiovasc. J. 2015 Jan 1; 49 (6): 357-60.

ObjectivePlatypnoea-orthodeoxia is a rare cause of dyspnoea and hypoxaemia induced by a change from supine to upright position resulting in veno-arterial shunting, usually through a patent foramen ovale. We aimed to describe our experience with closure of a patent foramen ovale in patients with platypnoea-orthodeoxia, and to increase awareness of this diagnosis.DesignEight patients (mean age 63 ± 12 years) were identified from hospital records between 2000 and 2013.ResultsThe underlying diseases were aortic aneurism (n = 3), cardiac transplantation (n = 2), left ventricular dilatation (n = 1), pulmonary fibrosis (n = 1), and recurrent pleural/pericardial effusion (n = 1). At presentation, mean oxygen saturation was 81 ± 8% in the upright position. All patients underwent transthoracic and transoesophageal echocardiography. Pulmonary pressures were normal at rest in all patients. A right-to-left shunt through a patent foramen was demonstrated after changing posture from supine to sitting. Closure of the patient foramen ovale was performed uncomplicated in all patients. Mean oxygen saturation post-procedure was 96 ± 2%. All but one patient experienced marked symptom relief.ConclusionThe majority of patients with platypnoea-orthodeoxia can benefit from treatment of the underlying condition. In the present cohort, patients underwent uncomplicated catheter-based closure of the patient foramen ovale with subsequent improvement of oxygen saturation and symptom improvement.

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