Platypnea orthodeoxia syndrome and bronchopleural fistula following right pneumonectomy: The first case of double misfortune following pneumonectomy

We report a case of post-pneumonectomy right to left shunting via patent foramen ovale (PFO) and bronchopleural fistula (BPF). Although the latter complication is well-known following pneumonectomy, the former is quite rare. In terms of post-pneumonectomy complications, no case has been reported, in which right to left shunting via PFO and BPF were synchronous. Low awareness of post-pneumonectomy PFO often results in delay of the appropriate management, like in our experience. The rarity and the complexity of our case as well as literature review of the post-pneumonectomy right to left shunting via PFO are summarized. With our case of post-pneumonectomy right to left shunting via PFO and BPF reviewed, we would like to show the rarity of our case and to enlighten all of the thoracic surgeons for early detection of this hemodynamic complication following pneumonectomy.