A RARE DYSPNEA - PLATYPNEA-ORTHODEOXIA AF TER PNEUMONECTOMY

Background. - A right-to-left shunting across a patent foramen ovale i s a rare cause of acute respiratory failure after pneumonectomy. Case reports. - We report two cases of posture dependent dyspnea (platypnea -orthodeoxia) secondary to postoperative right-to-left shunting accros s a patent foramen ovale. Both cases occured three months after pneumo nectomy, the first in a 63-year-old man and other in a 52-year-old man . Conclusion. - A platynea-orthodeoxia (dyspnea induced by the upright position with arterial deoxygenation relieved by recumbency) should l ead to the diagnosis which is confirmed by echography or cardiac cathe terization. The prognosis is good after surgical closure of the patent foramen ovale. The physiopathologic mechanism is poorly understood. W e report two cases of platypnea-orthodeoxia. (C) 1998, Elsevier, Paris .