Pulmonary Vein Thrombosis Following Bilobectomy

Hovaguimian, Hagop; Morris, James F.; Gately, Hugh L.; Floten, H.Storm

doi:10.1378/chest.99.6.1515

Cited by 33 publications

(24 citation statements)

References 6 publications

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“…Another type is thrombus in the stump of the RSPV branch after right upper or middle lobectomies; such a thrombus could obstruct the remaining branch of the RSPV. This thrombus has been reported in 8 cases [16][17][18][19][20][21][22]; it may be caused by damaged vascular endothelium and is likely to cause obstruction of the remaining branches of the RSPV rather than embolism to vital organs.…”

Section: Discussionmentioning

confidence: 99%

Thrombosis in the Pulmonary Vein Stump After Left Upper Lobectomy as a Possible Cause of Cerebral Infarction

Ohtaka

Hida

Kaga

et al. 2013

The Annals of Thoracic Surgery

127

180

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OBJECTIVE: Thrombus in the stump of the pulmonary vein (PV) is not a well-known complication after lung resection, and it has the potential to cause embolism to vital organs. To clarify the frequency, risk factors, and cause of this complication, a retrospective clinical study of patients who underwent lobectomy was performed.METHOD: The subjects were 193 patients with primary lung cancer who underwent lobectomy from 2005 to 2011 and contrast-enhanced chest CT within 2 years after lobectomy. Contrast-enhanced CT was retrospectively interpreted to check for thrombus in the PV stump.RESULTS: The operative procedures were 65 right upper lobectomies, 14 right middle lobectomies, 40 right lower lobectomies, 52 left upper lobectomies (LUL), and 22 left lower lobectomies. Of the 193 patients, 7 (3.6%) developed thrombus in the PV stump after lobectomy. All patients with thrombus had undergone LUL, and 13.5% of those who had undergone LUL developed thrombus. Univariate analyses revealed that LUL and operation time were significant risk factors, and that adjuvant chemotherapy was marginally significant. It appears that thrombus may be attributable to the length of the PV stump. Measurement of the length of the PV stump using three-dimensional CT images of the PV revealed that the stump of the left superior PV was longer than the others.CONCLUSION: Thrombus in the PV stump occurred in 13.5% of cases after LUL. These findings suggest that contrast-enhanced CT should be recommended for patients after LUL to help identify patients with a high risk for thromboembolism.(246 words)

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Section: Discussionmentioning

confidence: 99%

Thrombosis in the Pulmonary Vein Stump After Left Upper Lobectomy as a Possible Cause of Cerebral Infarction

Ohtaka

Hida

Kaga

et al. 2013

The Annals of Thoracic Surgery

127

180

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“…However, successful clot resolution has been reported with anticoagulation (1,2). Early diagnosis and treatment can help to prevent the other potential complications, including pulmonary gangrene, peripheral embolus, and massive haemoptysis (3).…”

Section: Discussionmentioning

confidence: 99%

Idiopathic Pulmonary Vein Thrombosis in a Patient with Chronic Obstructive Pulmonary Disease

Shand¹,

Bradley²,

Schauer³

2016

Eurasian J Pulmonol

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We present the case of a 67-year-old man who presented to our hospital with acute shortness of breath. He was initially treated for a presumed infective exacerbation of chronic obstructive pulmonary disease (COPD) but did not respond to standard therapy. Further investigations were performed and revealed a large pulmonary vein thrombus. Clinical, laboratory, and radiological investigation did not identify an underlying cause for his thrombus. Idiopathic pulmonary vein thrombosis is much rarer than the more well-known pulmonary embolism and is worthy of consideration as an uncommon cause of pulmonary decline. To our knowledge, this is the first case report in the English literature of idiopathic pulmonary vein thrombus occurring in the setting of known COPD.

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“…The variant of RMLV drainage via the RIPV may result in life-threatening post-operative haemoptysis and respiratory distress in case of right lower lobectomy. Therefore, careful pre-operative assessment of the pulmonary venous return is crucial in patients undergoing pulmonary surgery [24,75,76]. In addition to congenital stenosis of pulmonary veins with normal connection, the varying forms of partial anomalous venous return may be combined with a pulmonary venous stenosis.…”

Section: Anatomy Of the Mediastinal Pulmonary Veinsmentioning

confidence: 99%

“…Besides the rare condition of congenital pulmonary venous stenosis, there are several clinical conditions predisposing to the obstruction of the central pulmonary veins, like mediastinal masses such as solid neoplasms or bulky lymphoma, fibrosing mediastinitis and mediastinal granulomatous diseases. In addition, lung transplantation [66,67] and lobectomy or bilobectomy [24] may result in pulmonary venous stenosis (table 1). Furthermore, cor triatriatum [53], left atrial myxoma and postpneumonectomy syndrome may cause functional pulmonary venous stenosis.…”

Section: Introductionmentioning

confidence: 99%

Haemoptysis due to pulmonary venous stenosis

Braun¹,

Platzek²,

Zöphel³

et al. 2014

European Respiratory Review

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Haemoptysis is a potentially life-threatening condition with the need for prompt diagnosis. In about 10-20% of all cases the bleeding source remains unexplained with the standard diagnostic approach. The aim of this article is to show the necessity of widening the diagnostic approach to haemoptysis with consideration of pulmonary venous stenosis as a possible cause of even severe haemoptysis and haemoptoe.A review of the literature was performed using the Medline/PubMed database with the terms: ''pulmonary venous stenosis'', ''pulmonary venous infarction'' and ''haemoptysis''. Further references from the case reports were considered.58 case reports and case collections about patients with haemoptysis due to pulmonary venous stenosis were detected. This review gives an overview about the case reports and discusses the underlying pathophysiology and the pros and cons of different imaging techniques for the detection of pulmonary venous stenosis.Several conditions predispose to the obstruction of the mediastinal pulmonary veins. Clinical findings are unspecific and may be misleading. Pulmonary venous stenosis can be detected using several imaging techniques, yet three-dimensional magnetic resonance-angiography and three-dimensional contrastenhanced computed tomography are the most appropriate. Pulmonary venous stenosis should be considered in patients with haemoptysis. @ERSpublications Pulmonary venous stenosis should be considered in haemoptysis and is best diagnosed using CT or MRI venography http://ow.ly/tMPFP

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Pulmonary Vein Thrombosis Following Bilobectomy

Cited by 33 publications

References 6 publications

Thrombosis in the Pulmonary Vein Stump After Left Upper Lobectomy as a Possible Cause of Cerebral Infarction

Thrombosis in the Pulmonary Vein Stump After Left Upper Lobectomy as a Possible Cause of Cerebral Infarction

Idiopathic Pulmonary Vein Thrombosis in a Patient with Chronic Obstructive Pulmonary Disease

Haemoptysis due to pulmonary venous stenosis

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