Dynamic shunt flow alterations through patent foramen ovale during off-pump coronary artery bypass grafting induced by airway pressure changes: a case report.

ABSTRACT:

Background

Interatrial right-to-left shunt flow through a patent foramen ovale (PFO) can be caused by changes in heart position for anastomosis during off-pump coronary artery bypass (OPCAB). We herein present a case in which the direction of PFO shunt flow changed with heart position during OPCAB and the ventilation settings after sternal closure.

Case presentation

A 66-year-old man with interstitial pneumonia underwent OPCAB. Preoperative transesophageal echocardiography revealed right-to-left shunt flow through a PFO induced by the Valsalva maneuver. During OPCAB, heart displacement resulted in right-to-left shunting and acute hypoxemia, which quickly improved with increase of inspired oxygen fraction. After chest closure, bidirectional shunt flow developed under increase

SUBMITTER: Honda A 

PROVIDER: S-EPMC11480267 | biostudies-literature | 2024 Oct

REPOSITORIES: biostudies-literature