Pulmonary vein thrombosis and cerebral infarction after video-assisted thoracic surgery of the left upper lobe: a case series

JA Clinical Reports

Yumiko Mori¹  Mitsuko Hashiguchi¹  Kei Kambara¹  Yosuke Fujii²  Kiichi Hirota³  Shogo Toda⁴  Masashi Yanada⁴ 

[1] Department of Anesthesia, Otsu City Hospital, 2-9-9, Motomiya, 520-0804, Otsu, Shiga, Japan;Department of Anesthesia, Otsu City Hospital, 2-9-9, Motomiya, 520-0804, Otsu, Shiga, Japan;Department of Human Stress Response Science, Institute of Biomedical Science, Kansai Medical University, 2-5-1, Shinmachi, 573-1010, Hirakata, Osaka, Japan;Department of Human Stress Response Science, Institute of Biomedical Science, Kansai Medical University, 2-5-1, Shinmachi, 573-1010, Hirakata, Osaka, Japan;Department of Thoracic surgery, Otsu City Hospital, 2-9-9, Motomiya, 520-0804, Otsu, Shiga, Japan;

关键词: Video-assisted thoracic surgery (VATS);    Left upper lobe;    Pulmonary vein thrombosis (PVT);    Thromboembolic complication;    Cerebral infarction;    Perioperative management;   

DOI  :  10.1186/s40981-020-00378-9

来源: Springer

【 摘 要 】

BackgroundPulmonary vein thrombosis (PVT) and cerebral infarction are rare but critical complications after video-assisted thoracic surgery (VATS).Case presentationWe 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.ConclusionPVT and cerebral infarction may occur after VATS-LUL. Appropriate postoperative management is required to recognize PVT and to prevent life-threatening stroke.

【 授权许可】

CC BY