Dyspnea following thoracostomy closure after right pneumonectomy: An uncommon echocardiographic diagnosis and therapeutic approach

Echocardiography. 2017 May;34(5):782-785. doi: 10.1111/echo.13505. Epub 2017 Mar 14.

Abstract

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.

Keywords: patent foramen ovale; percutaneous intervention; three-dimensional transesophageal echocardiography; transesophageal Echocardiography.

Publication types

  • Case Reports

MeSH terms

  • Diagnosis, Differential
  • Dyspnea / diagnosis
  • Dyspnea / etiology*
  • Dyspnea / prevention & control
  • Dyspnea / therapy
  • Echocardiography / methods*
  • Foramen Ovale, Patent / diagnostic imaging*
  • Foramen Ovale, Patent / etiology
  • Foramen Ovale, Patent / therapy*
  • Humans
  • Male
  • Middle Aged
  • Pneumonectomy / adverse effects*
  • Rare Diseases / diagnosis
  • Rare Diseases / etiology
  • Rare Diseases / therapy
  • Thoracostomy / adverse effects*
  • Treatment Outcome
  • Wound Closure Techniques / adverse effects*