Platypnoea Orthodeoxia Syndrome and Patent Foramen Ovale Closure: Single-Centre Experience and Long-Term Follow-Up.

Autor: Gama E Castro A; ICBAS School of Medicine and Biomedical Sciences, Porto University, Porto, Portugal., Luz A; Department of Cardiology, Centro Hospitalar Universitário do Porto (CHUPorto), Porto, Portugal; ICBAS School of Medicine and Biomedical Sciences, Porto University, Porto, Portugal; Cardiovascular Research Group - Unit of Multidisciplinary Investigation in Biomedicine, ICBAS, Porto University, Porto, Portugal. Electronic address: andrecoimbraluz@hotmail.com., Oliveira F; Department of Cardiology, Centro Hospitalar Universitário do Porto (CHUPorto), Porto, Portugal; ICBAS School of Medicine and Biomedical Sciences, Porto University, Porto, Portugal., Brochado B; Department of Cardiology, Centro Hospitalar Universitário do Porto (CHUPorto), Porto, Portugal; ICBAS School of Medicine and Biomedical Sciences, Porto University, Porto, Portugal., Santos R; Department of Cardiology, Centro Hospitalar Universitário do Porto (CHUPorto), Porto, Portugal; ICBAS School of Medicine and Biomedical Sciences, Porto University, Porto, Portugal., Alexandre A; Department of Cardiology, Centro Hospitalar Universitário do Porto (CHUPorto), Porto, Portugal; ICBAS School of Medicine and Biomedical Sciences, Porto University, Porto, Portugal., Campinas A; Department of Cardiology, Centro Hospitalar Universitário do Porto (CHUPorto), Porto, Portugal; ICBAS School of Medicine and Biomedical Sciences, Porto University, Porto, Portugal., Couto DS; Department of Cardiology, Centro Hospitalar Universitário do Porto (CHUPorto), Porto, Portugal; ICBAS School of Medicine and Biomedical Sciences, Porto University, Porto, Portugal., Silveira J; Department of Cardiology, Centro Hospitalar Universitário do Porto (CHUPorto), Porto, Portugal; ICBAS School of Medicine and Biomedical Sciences, Porto University, Porto, Portugal., Torres S; Department of Cardiology, Centro Hospitalar Universitário do Porto (CHUPorto), Porto, Portugal; ICBAS School of Medicine and Biomedical Sciences, Porto University, Porto, Portugal.
Jazyk: angličtina
Zdroj: Heart, lung & circulation [Heart Lung Circ] 2022 Nov; Vol. 31 (11), pp. 1547-1552. Date of Electronic Publication: 2022 Aug 18.
DOI: 10.1016/j.hlc.2022.07.003
Abstrakt: Introduction: Platypnoea orthodeoxia syndrome (POS) is an uncommon condition characterised by dyspnoea and arterial desaturation induced by an upright position and relieved in the supine position, usually due to a patent foramen ovale (PFO). Percutaneous closure of a PFO is the preferred treatment to cure POS. This study aimed to evaluate the clinical and gasometrical characteristics and to describe the long-term outcomes of percutaneous PFO closure in a group of patients with POS.
Methods: Patients with POS and a PFO treated by percutaneous intervention from 2010-2020 were reviewed. The primary efficacy outcome was the arterial oxygen pressure to fraction of inspired oxygen (PaO 2 /FiO 2 ) ratio before and 24 hours after the procedure. Total clinical success was considered if the arterial oxygen saturation measured by pulse oximetry (SpO 2 ) improved to >94% in the supine and sitting positions without supplemental oxygen, while partial success was considered if SpO 2 improved from baseline but still required oxygen to achieve >94%. Secondary outcomes were an absolute improvement in SpO 2 and sense of dyspnoea, without significant residual shunt on transthoracic echocardiography (TTE) at follow-up.
Results: Of 168 patients undergoing PFO or atrial septal defect closure, 14 had POS (8.3%). Percutaneous PFO closure was successfully performed in all patients with a single device. Twelve of 14 patients had total clinical success (86%) and one patient had partial success. The PaO 2 /FiO 2 ratio increased from 155.9±50.6 to 318.3±73.4 after PFO closure (p=0.002). All patients with total clinical success had a successful secondary efficacy outcome with an absolute improvement in SpO 2 and complete resolution of dyspnoea, which was maintained at follow-up (37±20 months; range, 11 months to 6 years). None had a significant residual shunt between 12 and 24 months of follow-up.
Conclusion: The PFO percutaneous closure was a successful, durable and safe method for patients presenting with POS; it achieved major improvements in both gasometrical parameters and quality of life.
(Copyright © 2022 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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