title: Contralateral pulmonary embolism caused by pulmonary artery stump thrombosis after pneumonectomy.
abstract: A 73-year-old man with atrial fibrillation and previous left pneumonectomy was admitted with pleural effusion. Anticoagulant therapy was discontinued because of chest tube drainage. Six days later, the patient experienced chest discomfort. Echocardiography showed a pedunculated thrombus with swaying motion in the left pulmonary artery (PA) stump. Contrast-enhanced computed tomography of the chest revealed filling defects in not only the left PA stump but also the right PA, implying contralateral pulmonary embolism. Anticoagulants were resumed, and thrombolysis was successful 3 days later. Patients undergoing pneumonectomy in whom anticoagulant therapy is discontinued should be recognized as being at high risk for PA stump thrombosis and subsequent contralateral pulmonary embolism.
authors.affiliation: Department of Cardiovascular and Respiratory Medicine, Akita University School of Medicine, Akita, Japan.
authors.forename: Wakana
authors.initials: W
authors.lastname: Sato
authors.affiliation: Department of Cardiovascular and Respiratory Medicine, Akita University School of Medicine, Akita, Japan. Electronic address: hirow@doc.med.akita-u.ac.jp.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Watanabe
authors.affiliation: Department of Cardiovascular and Respiratory Medicine, Akita University School of Medicine, Akita, Japan.
authors.forename: Teruki
authors.initials: T
authors.lastname: Sato
authors.affiliation: Department of Cardiovascular and Respiratory Medicine, Akita University School of Medicine, Akita, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Iino
authors.affiliation: Department of Cardiovascular and Respiratory Medicine, Akita University School of Medicine, Akita, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Sato
authors.affiliation: Department of Cardiovascular and Respiratory Medicine, Akita University School of Medicine, Akita, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ito
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000368:Aged; D000792:Angiography / Q000379:methods; D000925:Anticoagulants / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000188:drug therapy; D003287:Contrast Media; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D018365:Neoplasm, Residual / Q000150:complications*; D010996:Pleural Effusion / Q000175:diagnosis / Q000209:etiology; D011013:Pneumonectomy / Q000009:adverse effects / Q000379:methods*; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology*; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler / Q000379:methods
chemical_list: D000925:Anticoagulants; D003287:Contrast Media