scholarly journals Very late unusual thrombosis of the remnant pulmonary vasculatures after lung resection complicated by embolic events

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Hyun Ju Yoon ◽  
Kye Hun Kim ◽  
Myung Ho Jeong ◽  
Jeong Gwan Cho ◽  
Jong Chun Park
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Artery ◽  
Lung Resection ◽  
Cardiovascular Imaging ◽  
Surgical Removal ◽  
Left Upper Lobectomy ◽  
Right Pulmonary Artery ◽  
History Of ◽  
Vascular Structures ◽  
The Right

Abstract Background Primary thrombosis of the pulmonary vasculatures without extra-pulmonary sources of embolism are uncommon. Here, we report 2 cases of thrombosis of the stump of the remnant pulmonary vasculatures after lung resection complicated by embolic events with review of the literature. Case presentation A 75-year-old female was consulted to evaluate cardiac source of embolism for acute cerebral infarction. The patient underwent left upper lobectomy because of lung cancer 2 years ago. Cardiovascular imaging revealed about 1.6 cm × 1.4 cm sized thrombus within the remnant stump of the left superior pulmonary vein. The patient was treated by anticoagulation with warfarin, because the patients refused surgical removal of thrombus. A 57-year-old female who had a history of right pneumonectomy 10 years ago presented with dyspnea. Cardiovascular imaging revealed 1.7 × 1.5 cm sized thrombus in the right pulmonary artery stump and small pulmonary embolism in the left lower segmental pulmonary artery. The patient was treated by long-term anticoagulation with warfarin, and the thrombus and pulmonary embolism were resolved. Conclusion The present cases demonstrated that very late thrombosis of the remnant pulmonary vascular structures and subsequent fatal embolic complications can develope even several years later after lung resection. Therefore, the dead space of the remnant vascular structures should be minimized during lung resection surgery, and the developement of delayed thromboembolic complications associated with vascular stump thrombosis should be carefully monitored.

scholarly journals P701 Usefulness of echocardiography in diagnosis and monitoring in patient with pulmonary embolism during pregnancy, a case report

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
K Starzyk ◽  
P Dybich ◽  
K Ciuraszkiewicz ◽  
W Rokita ◽  
B Wozakowska-Kaplon
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Artery ◽  
Troponin T ◽  
Pulmonary Arteries ◽  
Pulmonary Trunk ◽  
Clinical State ◽  
Main Trunk ◽  
Right Pulmonary Artery ◽  
Low Incidence ◽  
The Right

Abstract Pulmonary embolism is one of the leading causes of maternal mortality despite a low incidence of during pregnancy. We present 32-year-old woman, in the 35 week of first pregnancy, admitted to the Intensive Care Unit with dyspnea, tachycardia, cyanosis. Echocardiography confirmed the presence of embolic material in the main trunk of pulmonary artery, spreading to the right pulmonary artery. D-dimer and troponin T level were elevated, BNP remained within the normal range. The risk in PESI scale was assumed as intermediate high. LMWH therapy was initiated, the patient was constantly monitored. Venous thrombotic disease in lower extremities was excluded by ultrasonography. The treatment was carried out under obstetric supervision. The clinical state gradually improved, the patient was hemodynamically stable. Serial echocardiographic testing, revealed gradual regression of changes in the pulmonary trunk. Normalization of troponins and lowering of BNP levels were observed. The pregnancy was terminated in 39 week, by cesarean section (obstetric indications). The LMWH was continued few days after delivery, as the patient started lactation. She decided to terminate lactation in a first week after delivery so the therapy was switched into rivaroxaban for at least 3 months. Echocardiography after 3 month confirmed lack of changes in pulmonary trunk, the risk of pulmonary hypertension was low. Echocardiography can be a method of choice for confirming and monitoring pulmonary embolism during pregnancy, in a situation of high or intermediate clinical risk and good visualization of changes in pulmonary arteries Abstract P701 Figure. Embolism of pulmonary trunk and RPA

scholarly journals P689 Surgical treatment of a right heart thrombus-in-transit with massive bilateral pulmonary embolism

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
C M Angelescu ◽  
I Hantulie ◽  
Z Galajda ◽  
I Mocanu ◽  
A T Paduraru ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Artery ◽  
Right Atrium ◽  
Intracardiac Thrombus ◽  
Severe Pulmonary Hypertension ◽  
Right Heart ◽  
Right Pulmonary Artery ◽  
The Right ◽  
In Transit ◽  
Right Heart Dysfunction

Abstract Introduction Right heart thrombi are rare, found in up to 20% of pulmonary emboli (PE), and associated with significantly increased mortality(1). A thrombus entrapped in a PFO is a rare form of right heart thromboembolism. Clinical Case A 73-year-old male patient who had dyspnea for 10 days, was transferred to our hospital for the surgical treatment of a cardiac tumor. We performed TTE which revealed a free floating, huge mass( measuring more than 8 cm long) in the right atrium, that protruded in the right ventricle, with high risk of embolization. Another smaller mass, attached to the interatrial septum. Severe right ventricular dysfunction and severe pulmonary hypertension were present. Contrast-enhanced computer tomography was performed, which revealed severe bilateral pulmonary artery emboli with complete occlusion of right pulmonary artery branch. Clinical and paraclinical data strongly suggested that the huge cardiac mass was a thrombus that originated from the lower extremity veins. TEE showed that the thrombus was entrapped through the PFO, with a smaller part in the left atrium and the biggest portion in the right atrium. The patient underwent an emergent on-pump surgical cardiac and right pulmonary artery embolectomy. The right atrium was opened and a huge intracardiac thrombus with a lengh of 14 cm extending from the coronary sinus, to PFO in the left atrium and also in the right ventricle was removed. The right branch of the pulmonary artery was opened and a large volume of clot- 9 cm long- was removed. The patient was removed from cardio-pulmonary by-pass (CPB) on high doses of norepinephrine and dobutamine and necessitated initiation of venous-arterial ECMO to support the severe right heart dysfunction. He was extubated after 10 days, with little improvement in the clinical status. Transthoracic echocardiography showed smaller right heart cavities), normal left ventricular function, but persistent severe RV dysfunction and severe pulmonary hypertension. In the thirteenth postoperative day, he installed cardio-respiratory arrest and he died. Discussion In this report we describe a case of a patient with a huge intracardiac thrombus, entrapped through a PFO, associated with massive pulmonary embolism, with late presentation in our hospital and severe refractory right heart dysfunction. He underwent successful embolectomy, which is a unique procedure in the treatment of an acute pulmonary embolism and entrapped thrombus in a PFO. Conclusion The treatment of choice for emboli-in-transit is controversial. In a recent review, surgical thromboembolectomy showed a trend toward improved survival and significantly reduced systemic emboli compared to anticoagulation. Thrombolysis in these patients may cause fragmentation of thrombus and systemic embolization, resulting in increased mortality. Management decisions should be made with multidisciplinary coordination and consideration of complicating factors such as PFO. Abstract P689 Figure. Extensive biatrial thrombus

scholarly journals Treatment of Mobile Right Heart Thrombi

2020 ◽  
Author(s):  
Xenofon M Sakellariou ◽  
Andreas Efstathopoulos ◽  
Konstantinos V Stamatis ◽  
Dimitrios N Nikas ◽  
Theofilos M Kolettis
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Artery ◽  
Optimal Strategy ◽  
Therapeutic Options ◽  
Right Heart ◽  
Half Dose ◽  
Right Pulmonary Artery ◽  
The Right

Right heart thrombi are detected in approximately 4% of patients with pulmonary embolism. The associated mortality is high, but the optimal strategy remains controversial. We report a case of a large mobile right heart thrombus, complicated by embolism of the right pulmonary artery, which was successfully treated with half-dose alteplase. We briefly review the literature and discuss the therapeutic options, focusing on the advantages of thrombolysis.

scholarly journals Case Report of Hydatid Cyst in the Pulmonary Artery Uncommon Presentation: CT and MRI Findings

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Arwa Almutairi ◽  
Sulaiman Al Rajhi
Keyword(s):  
Pulmonary Artery ◽  
Hydatid Cyst ◽  
Hydatid Cysts ◽  
Mri Findings ◽  
Hepatic Hydatid Cyst ◽  
Uncommon Presentation ◽  
Right Pulmonary Artery ◽  
History Of ◽  
The Right ◽  
Ct And Mri

Background. Hydatid cysts can be found in any organ. In adults, the liver and lungs are the most common locations; hydatid cysts in the pulmonary artery are rare.Clinical Case. We present the case of an 86-year-old female with a history of hepatic hydatid cyst since 2012, who presented with complaints of chronic productive cough, yellowish-green sputum, and dyspnea. CT and MRI showed multiseptate hydatid cysts in the right pulmonary artery.

scholarly journals Iatrogenic Insertion of Chest Tube inside the Right Pulmonary Artery: Unique, Unheard Complication, and Management

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Arun Kumar Haridas ◽  
Arpan Shah ◽  
Umang Shah ◽  
Chandrakant Shah ◽  
Jayesh Rajpura
Keyword(s):  
Pulmonary Artery ◽  
Chest Tube ◽  
Tertiary Care ◽  
Disease Patient ◽  
Diffuse Fibrosis ◽  
Surgical Removal ◽  
Medical College ◽  
Chest Physician ◽  
Right Pulmonary Artery ◽  
The Right

A 75-year-old male patient referred from a medical college for emergency surgical removal of chest tube from the right pulmonary artery, inserted while treating a right-sided pneumothorax. The patient was a known case of COVID pneumonia treated successfully, 2 months back. The patient developed sudden breathlessness and chest pain with saturation of 70%. The patient had gone to nearest medical college for evaluation. Chest X-ray showed right-sided pneumothorax. Chest physician inserted intercostal chest tube. After insertion of chest tube, the patient drained 1500 ml of frank blood. Chest tube clamped and referred to a tertiary care center. Emergency computed tomography (CT) pulmonary angiogram is done. It showed chest tube tip in the right pulmonary artery. In view of post-COVID, severe interstitial lung disease, patient was not suitable for open heart surgery with the support of heart-lung machine. The patient was stable when we were received; saturation was 90% with 5 L oxygen. CT chest showed diffuse fibrosis and resolving pneumonia. Echo showed severe pulmonary arterial hypertension. We did high-risk off- pump right thoracotomy and removed chest tube without much loss of blood. The injured right pulmonary artery repaired. Post-operative period was free of events and discharged successfully. In complicated cases, preferably thoracic surgeon and a well-trained, experienced chest physician should insert chest tube to avoid life-threatening complications.

scholarly journals A Rare Case of Adult Aortopulmonary Window Combined with Anomalous Origin of the Right Pulmonary Artery from the Aorta Leading to Eisenmenger Syndrome

2021 ◽  
Vol 49 (1) ◽  
pp. 030006052098465
Author(s):  
Mingyue Cui ◽  
Binfeng Xia ◽  
Heru Wang ◽  
Haihui Liu ◽  
Xia Yin
Keyword(s):  
Pulmonary Artery ◽  
Rare Case ◽  
Congenital Heart ◽  
Respiratory Tract Infections ◽  
Anomalous Origin ◽  
Aortopulmonary Window ◽  
Eisenmenger Syndrome ◽  
Right Pulmonary Artery ◽  
The Right ◽  
Tract Infections

Aortopulmonary window is a rare congenital heart disease that can increase pulmonary vascular resistance, exacerbate left-to-right shunt and lead to heart failure and respiratory tract infections. Most patients die during childhood. We report a 53-year-old male patient with a large aortopulmonary window combined with anomalous origin of the right pulmonary artery from the aorta, with Eisenmenger syndrome and without surgery.

Neonatal transcatheter closure of a right pulmonary artery to left atrium fistula

2021 ◽  
pp. 1-3
Author(s):  
Claire Bertail-Galoin
Keyword(s):  
Prenatal Diagnosis ◽  
Pulmonary Artery ◽  
Left Atrium ◽  
Neonatal Period ◽  
Transcatheter Closure ◽  
Rare Entity ◽  
Amplatzer Duct Occluder ◽  
Right Pulmonary Artery ◽  
The Right ◽  
Surgical Treatments

Abstract A fistula between the pulmonary artery and the left atrium is a rare entity and its diagnosis is uncommon in the neonatal period. There are more reported surgical treatments in the literature than with a transcatheter closure. We report the case of a prenatal diagnosis of a large fistula between the right pulmonary artery and the left atrium with successful transcatheter closure with an Amplatzer duct occluder II 6/4 mm.

Anomalous origin of the right pulmonary artery from the ascending aorta: Diagnosis by magnetic resonance imaging

1995 ◽  
Vol 18 (2) ◽  
pp. 118-121 ◽  
Author(s):  
Tae Kyoung Kim ◽  
Yeon Hyoen Choe ◽  
Hak Soo Kim ◽  
Jae Kon Ko ◽  
Young Tak Lee ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Pulmonary Artery ◽  
Ascending Aorta ◽  
Anomalous Origin ◽  
Resonance Imaging ◽  
Right Pulmonary Artery ◽  
The Right
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