PATENT FORAMEN OVALE PRESENTING AS REFRACTORY HYPOXEMIA AFTER HEART-TRANSPLANTATION

Hypoxemia can be an early life-threatening complication of orthotopic heart transplantation. Commonly, hypoxemia after orthotopic heart tran splantation is due to pulmonary hypertension or pulmonary complication s. Rarely, structural defects either in the donor or recipient heart c an lead to life-threatening hypoxemia. This case illustrates hypoxemia after orthotopic heart transplantation caused by the development of a right-to-left shunt through a patent foramen ovale in the recipient w hich had preoperatively been hemodynamically insignificant. The refrac tory hypoxemia required emergency surgical correction of the patent fo ramen ovale within the first postoperative week. In addition, this cas e illustrates the unique application of different methods of echocardi ograms providing noninvasive diagnosis of structural defects in orthot opic heart transplantation.