Dual thrombosis of the pulmonary arterial and venous anastomotic sites after single lung transplantation: role of transesophageal echocardiography in diagnosis and management.
We present the case of a patient who developed severe respiratory and hemodynamic compromise shortly after single right lung transplantation. Transesophageal echocardiography showed a large intraluminal thrombus at the right pulmonary artery anastomosis resulting in severe obstruction to flow together with thrombosis of the right pulmonary veins extending into the left atrium. After thrombectomy and surgical revision of the vascular anastomoses, the patient made an uneventful recovery. This case illustrates the usefulness of transesophageal echocardiography in the diagnosis and treatment of patients who are hemodynamically unstable after lung transplantation.
Fadel
Bahaa M
BM
Heart Institute, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. bmfadel@yahoo.com <bmfadel@yahoo.com>
Abdulbaki
Khaled
K
Nambiar
Vijayaraghavan
V
Al Amri
Mohammad
M
Shahid
Maie
M
Khouqeer
Farid
F
Canver
Charles
C
D000328:Adult; D001163:Arteriovenous Anastomosis; D015150:Echocardiography, Doppler; D017548:Echocardiography, Transesophageal / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016040:Lung Transplantation / Q000379:methods*; D011183:Postoperative Complications; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D011658:Pulmonary Fibrosis / Q000601:surgery*; D011667:Pulmonary Veins / Q000000981:diagnostic imaging / Q000601:surgery*; D012086:Reoperation; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology*; D017211:Treatment Failure; D014656:Vascular Surgical Procedures / Q000379:methods