{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T16:20:37Z","timestamp":1787847637772,"version":"build-2784847793"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>Hypoxia can occur after repair of transposition of great arteries. The most common cause of right to left shunt after arterial switch surgery is related to increased right ventricular pressures and persistent neonatal pulmonary arterial hypertension. We report a case of TGA repair causing right to left shunt with normal right ventricular pressures. Persistence of Eustachian valve with patent foramen ovale (PFO) is the unusual cause of hypoxia and desaturation. The patient was successfully managed by excision of Eustachian valve and closure of PFO.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/aca.aca_152_19","type":"journal-article","created":{"date-parts":[[2021,4,19]],"date-time":"2021-04-19T11:23:44Z","timestamp":1618831424000},"page":"241-243","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Hypoxia Due to Unusual Right to Left Shunt after Arterial Switch Surgery"],"prefix":"10.4103","volume":"24","author":[{"given":"Suresh Rao Kemundel","family":"Genny","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vignesh","family":"Kumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ganapathy","family":"Subramaniam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"KR","family":"Balakrishnan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-21-20240901","first-page":"338","article-title":"Hypoxemia and pulmonary hyper perfusion due to systemic collateral arteries after total repair of transposition of the great arteries","volume":"30","author":"Aghaji","year":"1989","journal-title":"J Cardiovasc Surg (Torino"},{"key":"R2-21-20240901","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.jccase.2018.01.003","article-title":"The findings in transposition of the great artery with severe persistent pulmonary hypertension of the Newborn","volume":"17","author":"Hoshino","year":"2018","journal-title":"J Cardiol Cases"},{"key":"R3-21-20240901","first-page":"30","article-title":"Persistent eustachian valve causing severe cyanosis in atrial septal defect with normal right atrial pressures","volume":"127","author":"Bashour","year":"1983","journal-title":"Angiology"},{"key":"R4-21-20240901","first-page":"33","article-title":"Prominent eustachian valve in newborns: A report of four cases","volume":"6","author":"Gad","year":"2016","journal-title":"AJP Rep"},{"key":"R5-21-20240901","doi-asserted-by":"crossref","first-page":"103","DOI":"10.4250\/jcu.2013.21.3.103","article-title":"Anatomic variants mimicking pathology on echocardiography: Differential diagnosis","volume":"21","author":"Kim","year":"2013","journal-title":"J Cardiovasc Ultrasound"},{"key":"R6-21-20240901","first-page":"336","article-title":"Giant eustachian valve with echocardiographic dividence of right atrium","volume":"29","author":"Yavuz","year":"2002","journal-title":"Tex Heart Inst J"},{"key":"R7-21-20240901","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.jsha.2012.12.002","article-title":"Chiari network: A case report and brief overview","volume":"31","author":"Islam","year":"2013","journal-title":"J Saudi Heart Assoc"},{"key":"R8-21-20240901","doi-asserted-by":"crossref","first-page":"86","DOI":"10.4103\/2211-4122.166084","article-title":"Transesophageal contrast echocardiography is not always the gold standard method in the identification of a patent foramen ovale: A clinical case","volume":"25","author":"Lunetta","year":"2015","journal-title":"J Cardiovasc Echogr"},{"key":"R9-21-20240901","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.ccl.2004.10.003","article-title":"Patent foramen ovale and the platypnea-orthodeoxia syndrome","volume":"23","author":"Chen","year":"2005","journal-title":"Cardiol Clin"},{"key":"R10-21-20240901","first-page":"57A","article-title":"The spinnaker effect: Platypnea-orthodeoxia syndrome due to PFO and aortic aneurysm","volume":"154","author":"Chai","year":"2018","journal-title":"Am Coll Chest Physician"},{"key":"R11-21-20240901","doi-asserted-by":"crossref","first-page":"211","DOI":"10.4103\/apc.APC_138_17","article-title":"Pulmonary artery-to-left atrial fistula discovered after closure of atrial septal defect: A rare clinical scenario","volume":"21","author":"Chauhan","year":"2018","journal-title":"Ann Paediatr Cardiol"}],"container-title":["Annals of Cardiac Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/aca.ACA_152_19","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T15:25:47Z","timestamp":1787844347000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/aca.ACA_152_19"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4]]},"references-count":11,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.4103\/aca.aca_152_19","relation":{},"ISSN":["0971-9784"],"issn-type":[{"value":"0971-9784","type":"print"}],"subject":[],"published":{"date-parts":[[2021,4]]}}}