# Platypnea-Orthodeoxia Syndrome and COVID-19 Successfully Treated With Percutaneous Patent Foramen Ovale Closure: A Report of Two Cases and Literature Review

## TL;DR

Two patients with severe COVID-19 and a rare breathing condition were successfully treated by closing a heart defect called patent foramen ovale.

## Contribution

This is the first report of successful PFO closure during acute COVID-19 in patients with platypnea-orthodeoxia syndrome.

## Key findings

- PFO closure resolved platypnea-orthodeoxia syndrome in two patients with severe COVID-19.
- Bubble echocardiography confirmed PFO with significant shunting in both cases.
- PFO closure during acute COVID-19 was safe and effective in these patients.

## Abstract

Platypnea-orthodeoxia syndrome (POS) is a rare clinical condition characterized by positional dyspnea and/or hypoxia. We report two cases of patients with COVID-19 bronchopneumonia with a torpid evolution. Due to clinical suspicion of POS, a diagnostic workup was performed, including a bubble echocardiography, which revealed a patent foramen ovale (PFO) with early and massive passage of bubbles to the left cavities. Both patients underwent percutaneous PFO closure with a resolution of POS. Here, we present the second and third cases of POS associated with PFO successfully closed during the acute phase of COVID-19. This suggests that PFO closure could be a potential treatment option for this condition.