This report describes a 37-year-old woman who experienced elevated serum carbohydrate antigen 19-9 (CA19-9) and carbohydrate antigen 50 (CA50). Intralobar pulmonary sequestration was confirmed via enhanced chest computed tomography (CT) scanning and positron emission tomography/computed tomography (PET/CT), which indicated two abnormal vessels arising from the descending thoracic aorta. Lobectomy of the left inferior lobe was performed as the optimal surgical approach and the pathological analysis met the diagnosis of intralobar pulmonary sequestration. Review of the patient's serum levels of CA50 and CA19-9 showed that these two tumor markers significantly decreased after surgery and finally went down to normal values. Therefore, the synchronically significant elevation of serum CA50 and CA19-9 was due to intralobar pulmonary sequestration.
Performing double valve replacement in a patient with previous pneumonectomy was challenging. Here, we reported a double valve replacement, which is performed in a 60-year-old female with a history of left pneumonectomy via median sternotomy. Multiple cerebral infarctions were confirmed by cranial computed tomography after surgery with none sequela left, which was suspected causing by air embolism. We review literatures from PubMed and conclude that median sternotomy is still the most common surgical approach. Due to the adhesions induced by previous operation, intraoperative air excluding is important for cardiothoracic surgeons to avoid air embolism after surgery. Post-surgery pulmonary hypertension is also worth paying attention to. Long-term follow-up is necessary to assess the outcomes of surgery.
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