open access

Vol 12, No 5 (2017)
Case Reports
Published online: 2017-11-22
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Significance of the patent foramen ovale for the candidate to the orthotopic liver transplantation

Katarzyna Żukowska, Piotr Kędzierski, Michalina Galas, Arkadiusz Pietrasik, Piotr Scisło, Joanna Raszeja-Wyszomirska, Renata Główczyńska
DOI: 10.5603/FC.2017.0093
·
Folia Cardiologica 2017;12(5):493-496.

open access

Vol 12, No 5 (2017)
Case Reports
Published online: 2017-11-22

Abstract

Persistent foramen ovale (PFO) is a congenital defect of interatrial septum, that in majority of patients stays asymptomatic. However, in conditions that lead to increased pressure in right atrium over left atrium, it may lead to blood shunt from the right to the left atrium. We are presenting a case report of 63-years-old male who was referred to the qualification for the orthotopic liver transplantation due to the decompensated liver cirrhosis. During transesophageal echocardiography with contrast PFO was detected. In the literature cases suggesting increased perioperative risk in patients with PFO are described. It is both related to air embolisms connected with the transplantation itself and possibility of crossed embolisms. For this reason, the patient was scheduled to the transcatheter PFO closure, after which he could have liver transplantation. The operation was performed a month later, uneventfully.

Abstract

Persistent foramen ovale (PFO) is a congenital defect of interatrial septum, that in majority of patients stays asymptomatic. However, in conditions that lead to increased pressure in right atrium over left atrium, it may lead to blood shunt from the right to the left atrium. We are presenting a case report of 63-years-old male who was referred to the qualification for the orthotopic liver transplantation due to the decompensated liver cirrhosis. During transesophageal echocardiography with contrast PFO was detected. In the literature cases suggesting increased perioperative risk in patients with PFO are described. It is both related to air embolisms connected with the transplantation itself and possibility of crossed embolisms. For this reason, the patient was scheduled to the transcatheter PFO closure, after which he could have liver transplantation. The operation was performed a month later, uneventfully.
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Keywords

end-stage liver disease, orthotopic liver transplantation, patent foramen ovale, paradoxical embolism, air embolism

About this article
Title

Significance of the patent foramen ovale for the candidate to the orthotopic liver transplantation

Journal

Folia Cardiologica

Issue

Vol 12, No 5 (2017)

Pages

493-496

Published online

2017-11-22

DOI

10.5603/FC.2017.0093

Bibliographic record

Folia Cardiologica 2017;12(5):493-496.

Keywords

end-stage liver disease
orthotopic liver transplantation
patent foramen ovale
paradoxical embolism
air embolism

Authors

Katarzyna Żukowska
Piotr Kędzierski
Michalina Galas
Arkadiusz Pietrasik
Piotr Scisło
Joanna Raszeja-Wyszomirska
Renata Główczyńska

References (9)
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  5. Olmedilla L, Garutti I, Pérez-Peña J, et al. Fatal paradoxical air embolism during liver transplantation. Br J Anaesth. 2000; 84(1): 112–114.
  6. Alba AC, Verocai Flaman F, Granton J, et al. Patent foramen ovale does not have a negative impact on early outcomes in patients undergoing liver transplantation. Clin Transplant. 2011; 25(1): 151–155.
  7. Werlang ME, Palmer WC, Boyd EA, et al. Patent foramen ovale in liver transplant recipients does not negatively impact short-term outcomes. Clin Transplant. 2016; 30(1): 26–32.
  8. Hagen PT, Scholz DG, Edwards WD. Incidence and size of patent foramen ovale during the first 10 decades of life: an autopsy study of 965 normal hearts. Mayo Clin Proc. 1984; 59(1): 17–20.
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