ArticleHeliyon2023
Tricuspid-regurgitation-mediated flow-driven right-to-left cardiac shunting caused systemic hypoxemia in a patient with patent foramen ovale without elevated right atrial pressure.
Article in Heliyon, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
4 citing papers in PubMed, 5 citations in OpenAlex.
- Flow-Driven Right-to-Left Shunting Through the Patent Foramen Ovale Causing Hypoxemia and Embolism in a Partial Uhl Anomaly.JACC. Case reports · 2026Article
- Case Report: unexpected cause of cyanosis in an infant after acute exposure to high altitude-severe tricuspid regurgitation secondary to tricuspid valve prolapse.Frontiers in cardiovascular medicine · 2024Article
- Case report: Anxiety and depression as initial symptoms in a patient with acute hypoxia and patent foramen ovale.Frontiers in psychiatry · 2023Article
- Patent Foramen Ovale Closure for Nonstroke Indications.Journal of the Society for Cardiovascular Angiography & InterventionsReview
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The prevalence of patent foramen ovale (PFO) is 20-25% among adults. The role of right-to-left shunting through the PFO in systemic hypoxemia remains poorly understood. Right-to-left shunting through the PFO can occur either due to elevated right atrial pressure (pressure-driven) or directed venous flow toward the PFO (flow-driven). Herein, we report a rare case of flow-driven right-to-left shunting via the PFO in a patient with traumatic tricuspid regurgitation. A 45-year-old Chinese woman was admitted due to progressive dyspnea for 3 years, presenting with cyanosis and digital clubbing. She was hypoxic, with an oxygen saturation of 83% on room air, and arterial blood gas showed an oxygen tension of 53 mmHg. Echocardiography showed severe tricuspid regurgitation with ruptured chordae tendinea, causing regurgitant jet flow directed toward the interatrial septum, leading to intermittent right-to-left shunting between the septa primum and secundum. Swan-Ganz catheterization revealed normal-high right atrial pressure and excluded pulmonary hypertension. The patient underwent tricuspid valve repair and PFO closure. Her oxygen saturation returned to 95% and her symptoms resolved. Right-to-left shunting through the PFO could cause systemic hypoxemia via a flow-driven mechanism, occasionally manifesting as cyanosis and clubbing digits. PFO closure and treatment of underlying disease are effective in improving hypoxemia.
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