TY - T1的不寻常的治疗全肺切除术后的卵圆孔未闭JF -欧洲呼吸杂志》乔和J SP - 929 LP - 931欧元——10.1183/09031936.00103509六世- 35 - 4盟Welvaart w . n . AU -贝克尔,a . AU -马库斯,J . t . AU - Vonk-Noordegraaf a . AU -自己本应从J·w·a . AU -保罗,M. a . Y1 - 2010/04/01 UR - //www.qdcxjkg.com/content/35/4/929.abstract N2 -给编辑:正如Harold C. Urschel Jr医生经常说的那样，肺切除术本身就是一种“疾病”。这是一种常见的围手术期并发症，如脓胸、瘘管、心脏问题或呼吸功能不全。除了术后频繁的心脏和呼吸系统并发症外，长期的后遗症也很常见。全肺切除术后，解剖适应性发生于胸内结构的重新定位。常见的变化有横膈抬高(特别是膈神经损伤后)、纵隔移位、肋间间隙缩小和肺切除术后间隙充满液体。这些适应可能导致失效的并发症，这种情况并不常见。最常见的并发症是所谓的肺切除术后综合征，其原因是残余支气管压迫脊柱或主动脉。由于器官定位可能需要数年时间，甚至在5-10年后症状也可能出现。在这篇文章中，我们将重点讨论一种罕见的并发症，即卵圆孔未闭(PFO)分流，它是右侧肺切除术或双叶切除术的长期并发症。 Only a few cases have been published, although this complication might be under-reported since the diagnosis of PFO is difficult, especially after pneumonectomy. This letter describes three patients who were diagnosed with shunting through a PFO following lung resection. In these patients, right ventricular compression by the elevated right hemidiaphragm was the main cause of PFO and surgical plication of the right hemidiaphragm was sufficient to close the PFO. Patient A A 67-yr-old male underwent a right-sided pneumonectomy 14 yrs earlier because of a bronchial carcinoid. Partial resection of the pericardium with transection of the phrenic nerve were needed for complete resection He developed progressive dyspnoea during exercise and when bending down. Echocardiography demonstrated a right-to-left interatrial shunt when increasing intra-abdominal pressure (valsalva manoeuvre) with a shunt fraction of 18%. Further analysis with right heart catheterisation at our institution showed a mean right atrial resting pressure (Pra … ER -