{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T02:56:17Z","timestamp":1769655377950,"version":"3.49.0"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T00:00:00Z","timestamp":1766534400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T00:00:00Z","timestamp":1769472000000},"content-version":"vor","delay-in-days":34,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["JA Clin Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Platypnea\u2013orthodeoxia syndrome (POS) is a rare condition causing dyspnea and hypoxemia that worsen in the upright position and improve when supine. While often reported in elderly patients, POS in young adults, particularly due to residual atrial septal defects (ASD) after congenital heart surgery, is uncommon.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>We present a 24-year-old woman with POS caused by a residual ASD following congenital heart surgery. Agitated saline contrast transthoracic echocardiography confirmed marked right-to-left shunting exacerbated by positional change and Valsalva maneuver.<\/jats:p>\n                    <jats:p>Anesthetic management focused on minimizing shunt flow by maintaining systemic vascular resistance, avoiding hypoxia, hypercarbia, and acidosis, and carefully adjusting ventilation parameters. Transesophageal echocardiography was utilized for shunt evaluation and device placement. Additionally, continuous cerebral oximetry was monitored for possible ischemic changes associated with paradoxical embolisms. The patient underwent successful percutaneous ASD closure without complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This rare case of young-onset POS highlights the importance of understanding the dynamic shunt physiology and vigilant intraoperative monitoring to ensure patient safety.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40981-025-00844-2","type":"journal-article","created":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T02:33:49Z","timestamp":1766543629000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Anesthetic management of Platypnea\u2013orthodeoxia syndrome in a young patient with residual atrial septal defect following congenital heart surgery"],"prefix":"10.1186","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-4336-7723","authenticated-orcid":false,"given":"Yoshifumi","family":"Naito","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Misao","family":"Yoshikawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michiyo","family":"Yamano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeshi","family":"Nakamura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fumimasa","family":"Amaya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,12,24]]},"reference":[{"key":"844_CR1","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1016\/j.rmed.2017.05.016","volume":"129","author":"A Agrawal","year":"2017","unstructured":"Agrawal A, Palkar A, Talwar A. The multiple dimensions of Platypnea-Orthodeoxia syndrome: a review. Respir Med. 2017;129:31\u20138.","journal-title":"Respir Med"},{"key":"844_CR2","doi-asserted-by":"publisher","first-page":"910","DOI":"10.1016\/j.echo.2015.05.015","volume":"28","author":"FE Silvestry","year":"2015","unstructured":"Silvestry FE, Cohen MS, Armsby LB, Burkule NJ, Fleishman CE, Hijazi ZM, et al. Guidelines for the echocardiographic assessment of atrial septal defect and patent foramen ovale: from the American Society of Echocardiography and Society for Cardiac Angiography and Interventions. J Am Soc Echocardiogr. 2015;28:910\u201358.","journal-title":"J Am Soc Echocardiogr"},{"key":"844_CR3","first-page":"274","volume":"92","author":"JL Salas-Pacheco","year":"2022","unstructured":"Salas-Pacheco JL. Mecanismos del s\u00edndrome de platipnea-ortodesoxia. 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