[Intraoperative right-to-left shunting induced by supine position in simultaneous lung resection with repair of atrial septal defect].

This report describes the case of a 49-year-old woman, who was suffered severe hypoxemia attributable to right-to-left shunting through an atrial septal defect (ASD) during the combined surgery for lung cancer and ASD in supine position. Right-to-left shunting has been reported to occur after lung resection but not during it. According to our continuous measurement of pulmonary arterial pressure and oxygen saturation, changes in hemodynamics during lobectomy in supine position was supposed to differ from that in lateral position, which may contribute to right-to-left shunting. A combined lung resection with heart surgery was performed safely and resulted in preventing postoperative complications induced by ASD.