Platypnoea-orthodeoxia syndrome following transcatheter aortic valve implantation complicated by aortic annular rupture: a case report

Platypnoea-orthodeoxia syndrome is a rare complication of TAVI, not previously reported after annular rupture. Aortic dilatation is often implicated in platypnoea-orthodeoxia, likely by compressing the interatrial septum and potentiating right-to-left shunting. In our patient, with a mildly dilated aorta prior to intervention, annular rupture and IMH may have further distorted atrial anatomy. Furthermore, rapid improvements in left ventricular compliance and left-sided filling pressures after TAVI may have facilitated the new onset of right-to-left shunting. Platypnoea-orthodeoxia syndrome should be considered in patients with unexplained hypoxaemia after TAVI.