Unexplained Hypoxia in Patient With Aortic Valve Replacement: Case of Hepatopulmonary Syndrome With Delayed Diagnosis

Abstract Hepatopulmonary syndrome (HPS) is a pulmonary complication that causes deterioration in oxygenation due to the inability to clear substances that will cause intrapulmonary vasodilation in advanced liver disease and the increase in vasodilator substances released from the liver (1). Hepatopulmonary syndrome may be misdiagnosed because of nonspecific symptoms and other comorbidities. There is no optimal medical therapy. However, the best treatment option is liver transplantation to improve oxygenation and survival (2) . We aimed to present a 44-year-old patient with a delayed diagnosis of HPS who had significant dyspnea and cyanosis and undergone cardiac surgery twice.