@article{JTD12404,
author = {Tomohiro Kamori and Gouji Toyokawa and Tatsuro Okamoto and Yuka Kozuma and Taichi Matsubara and Naoki Haratake and Shinkichi Takamori and Takaki Akamine and Kazuki Takada and Masakazu Katsura and Fumihiro Shoji and Yoshihiko Maehara},
title = {Pulmonary vein stump thrombosis after left pneumonectomy, diagnosed based on a high plasma D-dimer level: a case report},
journal = {Journal of Thoracic Disease},
volume = {9},
number = {3},
year = {2017},
keywords = {},
abstract = {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. Although the Postoperative course after re-operation was uneventful, and the patient was scheduled to be discharged on POD 12 when the serum creatinine level and plasma D-dimer level increased to 1.34 mg/dL and 17.4 μg/mL respectively. CT images revealed a giant thrombus in the left superior pulmonary vein (LSPV) stump, and we immediately started anticoagulant therapy of apixaban at 10 mg/day. We confirmed that the thrombus was reduced in size on POD 30, and the patient was discharged without any further complications. The elevated plasma D-dimer level was a key finding in this case for diagnosing pulmonary vein stump thrombosis (PVT) after left lung surgery. The 23 reported cases of PVT were found incidentally through follow-up CT scan or after serious complications occurred. This is the first case reporting the utility of the plasma D-dimer test for diagnosing PVT after surgical resection of the left lung. Early detection of PVT by a plasma D-dimer test may therefore positively contribute to better outcomes in the postoperative course of surgical resection of the left lung.},
issn = {2077-6624}, url = {https://jtd.amegroups.org/article/view/12404}
}