{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T23:10:28Z","timestamp":1740179428050,"version":"3.37.3"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2020,11,22]],"date-time":"2020-11-22T00:00:00Z","timestamp":1606003200000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,12,1]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Aortic aneurysms are known to cause compression of adjacent structures including the tracheobronchial tree, oesophagus, and recurrent laryngeal nerve. Extremely rarely, they can lead to compression of the tricuspid valve (TV) annulus. We describe a case where aortic aneurysm caused TV annulus compression and persistent right-to-left shunt through a patent foramen ovale (PFO).<\/jats:p>\n <\/jats:sec>\n \n Case summary<\/jats:title>\n A 75-year-old female was admitted with headache and dizziness. On examination, she had persistent arterial desaturation with oxygen levels reduced to 69% at rest whilst breathing ambient air. Complete blood count demonstrated polycythaemia (Hb 174\u2009g\/L). Right to left cardiac shunt was suspected after significant lung and haematologic pathology was excluded. Transoesophageal echocardiography demonstrated a trileaflet aortic valve with an ascending aorta aneurysm and a stretched PFO with persistent right to left shunt across it. The ascending aortic aneurysm was observed coursing superior to and compressing the TV annulus. Invasive haemodynamic data demonstrated prominent \u2018a\u2019 waves in the right atrium, low RV (12\/1\u2009mmHg), and pulmonary artery pressures (14\/6\u2009mmHg), reduced cardiac output and significant right to left shunt with Qp:Qs 0.6. Computed tomography (CT) angiogram demonstrated a 5\u2009cm fusiform ascending aorta aneurysm that coursed anteriorly causing TV annulus compression.<\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n Tricuspid valve inflow obstruction associated with a right to left shunt across PFO can be an extremely rare complication of aortic aneurysm. This may result in persistent arterial hypoxaemia and secondary polycythaemia.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaa453","type":"journal-article","created":{"date-parts":[[2020,11,22]],"date-time":"2020-11-22T01:46:35Z","timestamp":1606009595000},"page":"1-5","source":"Crossref","is-referenced-by-count":0,"title":["Extrinsic tricuspid valve compression due to an aortic aneurysm causing significant right to left shunt via a patent foramen ovale: a case report"],"prefix":"10.1093","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6877-2662","authenticated-orcid":false,"given":"Rizwan","family":"Ahmed","sequence":"first","affiliation":[{"name":"Institute of Cardiac Sciences, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,11,21]]},"reference":[{"key":"2021010812302319800_ytaa453-B1","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1016\/j.jcmg.2013.10.015","article-title":"The role of imaging in aortic dissection and related syndromes","volume":"7","author":"Baliga","year":"2014","journal-title":"JACC Cardiovasc Imaging"},{"key":"2021010812302319800_ytaa453-B2","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.jtcvs.2018.10.155","article-title":"Long-term experience with valve-sparing reimplantation technique for the treatment of aortic aneurysm and aortic regurgitation","volume":"158","author":"Mastrobuoni","year":"2019","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2021010812302319800_ytaa453-B3","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2014-205005","article-title":"Chronic cough: a herald symptom of thoracic aortic aneurysm in a patient with a bicuspid aortic valve","volume":"2014","author":"Miller","year":"2014","journal-title":"BMJ Case Rep"},{"key":"2021010812302319800_ytaa453-B4","doi-asserted-by":"crossref","first-page":"e377","DOI":"10.1016\/j.crvasa.2014.12.001","article-title":"Left main bronchus compression by massive thoracic aorta aneurysm as a cause of dyspnea","volume":"57","author":"Sova","year":"2015","journal-title":"Cor Vasa"},{"key":"2021010812302319800_ytaa453-B5","article-title":"Thoracic aortic aneurysm presenting with dysphagia: a fatal delay in diagnosis","volume":"4","author":"Hiller","year":"2007","journal-title":"Thorac Surg Sci"},{"key":"2021010812302319800_ytaa453-B6","first-page":"1","article-title":"Hoarseness due to aortic arch aneurysms","author":"Yuan","year":"2020","journal-title":"Braz J Cardiovasc Surg"},{"key":"2021010812302319800_ytaa453-B7","first-page":"123","article-title":"Aortic aneurysm producing back pain, bone destruction, and paraplegia","author":"Rothschild","year":"1982","journal-title":"Clin Orthop Relat Res"},{"key":"2021010812302319800_ytaa453-B8","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1080\/08998280.2018.1559387","article-title":"Patent foramen ovale and ascending aortic aneurysm causing the platypnea-orthodeoxia syndrome","volume":"32","author":"Agdamag","year":"2019","journal-title":"Baylor Univ Med Cent Proc"},{"key":"2021010812302319800_ytaa453-B9","first-page":"445","article-title":"Ascending aortic aneurysm and patent foramen ovale: a rare cause of platypnea-orthodeoxia","volume":"30","author":"Baptista","year":"2011","journal-title":"Rev Port Cardiol"},{"key":"2021010812302319800_ytaa453-B10","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1111\/j.1540-8167.2011.02245.x","article-title":"Severe deformation of right atrium and tricuspid annulus due to compression by tortuous aorta","volume":"23","author":"Mori","year":"2012","journal-title":"J Cardiovasc Electrophysiol"},{"key":"2021010812302319800_ytaa453-B11","doi-asserted-by":"crossref","first-page":"e90","DOI":"10.1016\/j.ijcard.2007.08.008","article-title":"Patent foramen ovale and ascending aortic aneurysm with platypnea-orthodeoxia syndrome","volume":"131","author":"Patan\u00e8","year":"2009","journal-title":"Int J Cardiol"}],"container-title":["European Heart Journal - 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