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

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Title: Thrombosis in the Pulmonary Vein Stump After Left Upper Lobectomy as a Possible Cause of Cerebral Infarction
Authors: Ohtaka, Kazuto Browse this author
Hida, Yasuhiro Browse this author →KAKEN DB
Kaga, Kichizo Browse this author
Kato, Tatsuya Browse this author
Muto, Jun Browse this author
Nakada-Kubota, Reiko Browse this author
Sasaki, Tsukasa Browse this author
Matsui, Yoshiro Browse this author
Issue Date: Jun-2013
Publisher: Elsevier
Journal Title: Annals of Thoracic Surgery
Volume: 95
Issue: 6
Start Page: 1924
End Page: 1929
Publisher DOI: 10.1016/j.athoracsur.2013.03.005
PMID: 23622699
Abstract: Background. 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. Methods. The study evaluated 193 patients with primary lung cancer who underwent lobectomy from 2005 to 2011 and contrast-enhanced chest computed tomography (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. Thrombus developed in the PV stump in 7 of the 193 patients (3.6%) 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 3-dimensional CT images of the PV revealed that the stump of the left superior PV was longer than the others. Conclusions. Thrombus in the PV stump occurred in 13.5% of patients after LUL. These findings suggest that contrast-enhanced CT should be recommended for patients after LUL to help identify those with a high risk for thromboembolism. (C) 2013 by The Society of Thoracic Surgeons
Type: article (author version)
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 樋田 泰浩

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