Patent Foramen Ovale Shunting Induced by Tricuspid Regurgitation: Unusual Cause of Dyspnea After Heart Transplantation.

ABSTRACT:

Background

Patent foramen ovale (PFO) is a common congenital anomaly that may contribute to hypoxemia and dyspnea.

Case summary

A 53-year-old woman presented with progressive platypnea and hypoxemia 21 years after orthotopic heart transplantation. Initial assessment revealed moderate tricuspid regurgitation (TR) and a PFO with left-to-right shunting. One year later, worsening dyspnea and desaturation were noted, with imaging confirming severe TR, right atrial dilation, and reversal of shunting to a right-to-left (pulmonary-to -systemic blood flow ratio: 0.79). Surgical tricuspid valve repair and PFO closure were performed, leading to complete symptom resolution and improved oxygenation.

Discussion

This case highlights the dynamic relationship between TR and PFO shunt

SUBMITTER: da Conceicao Nicolau Madogolele H 

PROVIDER: S-EPMC12478490 | biostudies-literature | 2025 Sep

REPOSITORIES: biostudies-literature