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Ann Thorac Surg 1991;52:865-867
© 1991 The Society of Thoracic Surgeons

Articles

Patent foramen ovale: A cause of hypoxemia in patients on left ventricular support

Robert T. Baldwin, MD, J.Michael Duncan, MD*, O.H. Frazier, MD, Susan Wilansky, MD

Cullen Cardiovascular Research Laboratories, Texas Heart Institute, Houston, Texas USA

Accepted for publication March 23, 1991.

* Address reprint requests to Dr Duncan, Texas Heart Institute, PO Box 20345, Houston, TX 77225.

We describe 2 patients who experienced right-to-left shunting during support with a left ventricular assist device as a result of patent foramen ovale. In the first patient, the patent foramen ovale was not found until autopsy. In the second patient, fluctuations in continuous mixed venous oxygen saturations caused us to suspect a patent foramen ovale, which was confirmed with transesophageal contrast echocardiography. We promptly repaired the defect and this patient survived. When patients on assist devices experience unexplained arterial hypoxemia, a patent foramen ovale should be considered. If a patent foramen ovale is found, surgical correction should be done early.




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