Valvular & structural heart diseaseMeta-analysis
Unmasking platypnoea-orthodeoxia syndrome: a systematic review of the pathophysiology, clinical spectrum and outcomes of percutaneous intracardiac shunt closure
- Systematic review
- case reports, case series and observational studies
Authors' conclusion
POS remains an underdiagnosed clinical entity, where systematic evaluation for POS should be considered in patients with positional desaturation and unexplained hypoxaemia. Percutaneous closure of the interatrial shunt offers significant symptomatic and physiological benefit with a favourable safety profile.
Study context
- Population
- Patients with intracardiac platypnoea-orthodeoxia syndrome (POS) undergoing percutaneous closure of patent foramen ovale (PFO)/atrial septal defect (ASD)patients from 196 studies · case reports/series 183 · observational studies 13
- Participants
- 469 patients
Pooled result
As reported in the abstract
Postclosure oxygen saturation
Further pooled results
Symptomatic improvement
- Symptomatic improvement
- 82% of cases
Baseline characteristics
- mean age
- 68.3±14.1 years
- female
- 51%
Symptoms
- orthodeoxia
- 95%
- exertional dyspnoea
- 42%
- platypnoea
- 35%
- median time from symptoms to diagnosis
- 13 (IQR 4-26) weeks
Anatomical contributors
- aortic dilation
- 33%
- thoracic structural abnormalities/surgery
- 33%
- right heart disorders
- 15%
Shunt characteristics
- mean PFO/ASD diameter
- 11.5±5.2 mm
- pulmonary blood flow/systemic blood flow ratio
- 0.89±0.34
Device used
- Amplatzer occluders
- 60% of closures
Safety
Procedural complication rate
- procedural complication rate
- 5%
Original publication
Unmasking platypnoea-orthodeoxia syndrome: a systematic review of the pathophysiology, clinical spectrum and outcomes of percutaneous intracardiac shunt closure. Heart. Published 18 March 2026. doi:10.1136/heartjnl-2025-327484
Summarised from the published abstract; every number is checked against it