Anesthetic management of Platypnea-orthodeoxia syndrome in a young patient with residual atrial septal defect following congenital heart surgery.

ABSTRACT:

Background

Platypnea-orthodeoxia syndrome (POS) is a rare condition causing dyspnea and hypoxemia that worsen in the upright position and improve when supine. While often reported in elderly patients, POS in young adults, particularly due to residual atrial septal defects (ASD) after congenital heart surgery, is uncommon.

Case presentation

We present a 24-year-old woman with POS caused by a residual ASD following congenital heart surgery. Agitated saline contrast transthoracic echocardiography confirmed marked right-to-left shunting exacerbated by positional change and Valsalva maneuver. Anesthetic management focused on minimizing shunt flow by maintaining systemic vascular resistance, avoiding hypoxia, hypercarbia, and acidosis, and carefully adjusting ventilation parameter

SUBMITTER: Naito Y 

PROVIDER: S-EPMC12847466 | biostudies-literature | 2025 Dec

REPOSITORIES: biostudies-literature