Background: A longer left superior pulmonary vein (LSPV) stump may increase the risk for postoperative cerebral infarction. Although the residual stump is generally longer after left upper lobectomy (LUL) than for other lobectomies, the length of the LSPV stump after LUL may be influenced by the anatomical relationship between the left atrial appendage (LAA) and the LSPV. Our aim in this study was to investigate the influence of this anatomical relationship on the residual length of the LSPV stump after LUL.
Methods: This was a retrospective analysis of 85 patients who underwent LUL at our institution, between January 2014 and March 2018. Based on pre-operative computed tomography (CT) images, the anatomical relationship between the LSPV and the LAA was classified into two patterns, namely an antero-superior and a postero-inferior pattern. The length of the LSPV stump for these two patterns was evaluated on postoperative CT images and compared between the two groups.
Results: Of the 85 patients, 49 were classified in the antero-superior pattern and 36 in the postero-inferior pattern. The mean length of the LSPV stump after LUL, overall, was 21.9 (range, 15-38) mm, with the stump being significantly longer for the antero-posterior (24.2 mm) than postero-inferior (18.9 mm) pattern.
Conclusions: The anatomical relationship between the LSPV and LAA, identified on pre-operative CT images, was associated with the length of the LSPV stump after LUL.
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http://dx.doi.org/10.21037/jtd-20-1170 | DOI Listing |
Magn Reson Med Sci
July 2022
Department of Respiratory Surgery, Nippon Medical School.
Purpose: The purpose of the current study was to clarify the blood flow pattern in the left atrium (LA), potentially causing the formation of thrombosis after left upper lobectomy (LUL). The blood flow in the LA was evaluated and compared between LUL patients with and without thrombosis. For the evaluation, we applied highly accelerated 4D flow MRI with dual-velocity encoding (VENC) scheme, which was expected to be able to capture slow flow components in the LA accurately.
View Article and Find Full Text PDFJ Thorac Dis
August 2020
Department of General Thoracic Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
Background: A longer left superior pulmonary vein (LSPV) stump may increase the risk for postoperative cerebral infarction. Although the residual stump is generally longer after left upper lobectomy (LUL) than for other lobectomies, the length of the LSPV stump after LUL may be influenced by the anatomical relationship between the left atrial appendage (LAA) and the LSPV. Our aim in this study was to investigate the influence of this anatomical relationship on the residual length of the LSPV stump after LUL.
View Article and Find Full Text PDFSci Rep
July 2019
Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
Retrospective studies have found that left upper lobectomy (LUL) may be a new risk factor for stroke, and the potential mechanism is pulmonary vein thrombosis, which more likely develops in the left superior pulmonary vein (LSPV) stump. The LSPV remaining after left pneumonectomy is similar to that remaining after LUL. However, the association between left pneumonectomy, LUL, and postoperative stroke remains unclear.
View Article and Find Full Text PDFJ Thorac Dis
March 2017
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
A 69-year-old man with locally advanced squamous cell lung cancer in the left hilum underwent left upper sleeve lobectomy following neoadjuvant chemoradiotherapy with an S-1/cisplatin regimen. On postoperative day (POD) 5, the chest X-ray findings deteriorated, and computed tomography (CT) images showed pulmonary congestion of the left residual lung. We then performed emergent left completion pneumonectomy.
View Article and Find Full Text PDFJ Cardiol Cases
July 2017
Department of General Thoracic Surgery, Okayama Saiseikai General Hospital, Okayama, Japan.
A 72-year-old man underwent video-assisted thoracoscopic left upper lobectomy for small cell lung cancer. After 16 days, he experienced epigastric abdominal pain and vomiting, and was taken by ambulance to our hospital. Contrast-enhanced computed tomography (CT) showed a propagation of thrombus in the stump of the left superior pulmonary vein (LSPV) complicated with splenic infarction.
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