Hemoptysis of pulmonary vein origin is extremely rare and difficult to manage. A 73-year-old man with a history of chronic heart failure presented with massive hemoptysis. Computed tomography showed an enhancing mass in the upper lobe of the left lung. Bronchial and pulmonary angiograms revealed no feeding vessels. Multidetector row computed tomography angiography showed a pulmonary vein flowing into the lung mass, suggesting that the bleeding had a pulmonary vein origin. Surgical resection of the left upper lobe was then performed. The pathologic diagnosis was lung abscess, with destruction of the pulmonary vein wall observed by elastica van Gieson stain.
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http://dx.doi.org/10.1016/j.atssr.2023.05.004 | DOI Listing |
Ann Thorac Surg Short Rep
December 2024
Division of Thoracic Surgery, Department of Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Background: Postoperative cerebral infarction, a serious complication of surgery, is occasionally experienced with pulmonary vein stump thrombosis (PVST), which is frequently observed after left upper lobectomy (LUL). Herein, we prospectively investigated whether PVST could be safely prevented by intrapericardial ligation of the superior pulmonary vein (SPV) to shorten the SPV stump during LUL.
Methods: In a consecutive 21 patients who underwent LUL, we ligated the proximal intrapericardial SPV with 1-0 silk suture and divided the distal hilar SPV by an automatic stapling device.
Ann Thorac Surg Short Rep
December 2024
Department of Pediatric Cardiac Surgery, Cleveland Clinic, Cleveland, Ohio.
Scimitar syndrome is a rare condition described by unique anatomic features that consist mainly of an abnormal connection of the right pulmonary veins to the inferior vena cava and right atrial junction, as well as an anomalous systemic arterial supply to the right lung. We present the case of a 60-year-old man with an atypical variant of scimitar syndrome that was embryologically perplexing and anatomically challenging to correct. We highlight key surgical and procedural considerations for a patient with scimitar syndrome presenting with this complex surgical anatomy.
View Article and Find Full Text PDFAnn Thorac Surg Short Rep
September 2024
Department of Cardiothoracic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Background: COVID-19 patients exhibit higher incidence of thrombosis in arteries and veins, including those in lungs. Vasa vasorum, which support large blood vessels, have shown involvement in these pathologic processes.
Methods: To further explore the extent of microvascular damage caused by COVID-19 infection, we examined resected main, right, or left pulmonary artery specimens from patients undergoing bilateral lung transplantation for COVID-19- or non-COVID-19-induced pulmonary fibrosis compared with organ donors by histologic and immunohistologic analyses.
Ann Thorac Surg Short Rep
September 2024
Biostatistics Unit, Department of Data Science, National Center for Child Health and Development, Tokyo, Japan.
Background: The primary treatment for hypoplastic left heart syndrome (HLHS) is the Fontan pathway, which entails performing the Glenn procedure. We hypothesized that the superior vena cava in patients with HLHS was short. As the length of the superior vena cava influences the Glenn procedure, we compared its length between patients with HLHS and those with other congenital heart diseases.
View Article and Find Full Text PDFAnn Thorac Surg Short Rep
June 2024
Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
A 55-year-old woman with no significant medical history or symptoms was incidentally diagnosed with a mediastinal tumor during a routine health checkup. The intraoperative findings of robot-assisted thoracoscopic surgery led to the diagnosis of extralobar pulmonary sequestration (EPS), with multiple vessels connecting to the pulmonary artery and superior pulmonary vein. EPS, an extremely rare condition, is typically supplied with blood from the aorta.
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