Pulmonary vein thrombosis after video-assisted thoracoscopic left upper lobectomy

Abstract Background Pulmonary vein thrombosis (PVT) and cerebral infarction are rare but critical complications after video-assisted thoracic surgery (VATS). Case presentation We experienced two cases of massive middle cerebral artery infarction after VATS for the left upper lobe. Although the precise source of their embolus was never identified, both cases were clinically suspected PVT. Unfortunately, case 2 died because of progressive cerebral herniation. We decided to perform contrast-enhanced computed tomography routinely after VATS for the left upper lobectomy (VATS-LUL) after these cases. Case 3, a 79-year-old female patient, underwent VATS-LUL for lung cancer. She developed PVT in the stump of the left upper pulmonary vein on postoperative day 4. Anti-coagulation therapy was begun immediately and continued for 3 months. She was free of complications 7 months after the operation. Conclusion PVT and cerebral infarction may occur after VATS-LUL. Appropriate postoperative management is required to recognize PVT and to prevent life-threatening stroke.

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Renal Infarction in a Patient with Pulmonary Vein Thrombosis after Left Upper Lobectomy

Case Reports in Nephrology and Urology ◽

10.1159/000363224 ◽

2014 ◽

Vol 4 (2) ◽

pp. 103-108 ◽

Cited By ~ 16

Author(s):

Shun Manabe ◽

Yasuko Oshima ◽

Marie Nakano ◽

Teruhiro Fujii ◽

Takamitsu Maehara ◽

...

Keyword(s):

Pulmonary Vein ◽

Renal Infarction ◽

Vein Thrombosis ◽

Left Upper Lobectomy

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A Case of Right Pulmonary Vein Thrombosis after Left Upper Lobectomy

International Journal of Pulmonary & Respiratory Sciences ◽

10.19080/ijoprs.2018.02.555597 ◽

2018 ◽

Vol 2 (5) ◽

Author(s):

Usama Talib

Keyword(s):

Pulmonary Vein ◽

Vein Thrombosis ◽

Left Upper Lobectomy

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Acute Limb Ischaemia Following Elective Left Upper Lobectomy for Early NSCLC: A Rare but Serious Complication Arising from the Pulmonary Vein Stump

10.31487/j.crss.2020.01.02 ◽

2020 ◽

pp. 1-2

Author(s):

James Elliott ◽

Anand Iyer ◽

James Elliott

Keyword(s):

Pulmonary Vein ◽

Ct Angiography ◽

Mediastinal Lymph Node ◽

Case Reports ◽

Common Femoral Artery ◽

Sudden Onset ◽

Leg Pain ◽

Limb Ischaemia ◽

Left Upper Lobectomy ◽

Acute Limb Ischaemia

Patients undergoing Left Upper Lobectomy (LUL) appear to be at risk of a unique post-operative complication that is not well-documented: Pulmonary Vein (PV) stump thrombosis +/- systemic arterial embolisation [1-3]. We describe the details of a rare case from our institution, present a review of this subject from the limited literature available, and suggest potential strategies to anticipate, detect and manage this entity. A 70 year old female patient underwent left upper lobectomy and mediastinal lymph node sampling via repeat left thoracotomy. The procedure was unremarkable apart from some adhesions. She progressed well post-operatively on the ward. On post-operative day 2 the patient developed sudden-onset left leg pain and paraesthesia and CT-Angiography confirmed the diagnosis of left common femoral artery embolus and left superior PV stump thrombosis. The patient returned to theatre for femoral embolectomy, continued systemic anticoagulation, and made an excellent recovery thereafter. The aetiology of this complication has been documented in some case reports, but it is not explored further in trials or thoracic surgery texts [2-3]. One cohort study involving CT-angiography after lobectomy surgeries found that left upper lobectomy was unique as a risk factor for PV stump thrombosis1. It may be related to the relatively longer LSPV stump and stasis of blood in the stump [4].

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