ARTERIAL DESATURATION AND ORTHODEOXIA AFTER ATRIAL SEPTAL-DEFECT REPAIR - DEMONSTRATION OF THE MECHANISM BY TRANSESOPHAGEAL AND CONTRAST ECHOCARDIOGRAPHY
Pm. Sapin et Rk. Salley, ARTERIAL DESATURATION AND ORTHODEOXIA AFTER ATRIAL SEPTAL-DEFECT REPAIR - DEMONSTRATION OF THE MECHANISM BY TRANSESOPHAGEAL AND CONTRAST ECHOCARDIOGRAPHY, Journal of the American Society of Echocardiography, 10(5), 1997, pp. 588-592
A young woman without symptoms underwent repair of an ostium secundum
atrial septal defect, and exertional dyspnea developed postoperatively
. This was found to be due to arterial oxygen desaturation which was e
xaggerated in the upright position and with exercise. Contrast echocar
diography confirmed a right-to-left shunt at the atrial level that was
shown only with femoral venous contrast injection and not with upper
extremity venous injection. Transesophageal echocardiography and subse
quent surgical exploration found that the Eustachian valve had been mi
staken for the inferior rim of the defect and sutured to the upper rim
of the defect. This created a channel through which blood from the in
ferior vena cava could be partially deferred to the left atrium.