Department of Cardiovascular and Respiratory Medicine, Akita University School of Medicine, Akita, Japan.
Department of Cardiovascular and Respiratory Medicine, Akita University School of Medicine, Akita, Japan.
Ann Thorac Surg. 2014 May;97(5):1797-8. doi: 10.1016/j.athoracsur.2013.07.102.
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.
一位 73 岁的男性，患有心房颤动和左侧肺切除术史，因胸腔引流而停止抗凝治疗。六天后，患者出现胸痛。超声心动图显示左肺动脉（PA）残端有一个带蒂血栓，呈摆动运动。胸部增强 CT 显示左 PA 残端和右 PA 均有充盈缺损，提示对侧肺栓塞。恢复抗凝治疗后，3 天后溶栓成功。接受肺切除术且停止抗凝治疗的患者应被视为 PA 残端血栓形成和随后对侧肺栓塞的高危人群。
