Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia · 2026
Impact of Left Atrial Hemodynamics on the Development of Pulmonary Vein Stump Thrombus: Results of Early and Late Postoperative Studies.
СтатьяНазвание и аннотация: Перевод в очереди
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Umehara Tadashi, Tokunaga Takuya, Takumi Koji, Kamimura Go, Aoki Masaya, Ueda Kazuhiro
Аннотация
PURPOSE: Pulmonary vein stump thrombus (PVST) is a relatively common complication after left upper lobectomy that can cause vital organ embolism. We previously found that patients with PVST on postoperative day 7 show risky hemodynamic features around the pulmonary vein stump on 4-dimensional (4D) flow magnetic resonance imaging (MRI), which may contribute to thrombus development. However, it remains unclear whether such hemodynamics persist later.
METHODS: Eleven patients who underwent left upper lobectomy for lung cancer received 4D flow MRI on postoperative day 7 and again after over 3 months. Hemodynamic parameters were used to classify each case as risky or non-risky for PVST.
RESULTS: According to a total of 24 examinations in 11 patients, 7 were classified as risky and 17 as non-risky. PVST developed in 6 patients during various postoperative phases, and all PVST cases developed under the risky conditions. Furthermore, PVST did not develop under non-risky conditions, suggesting that our risk assessment is valid as a predictive marker for PVST.
CONCLUSION: Our results suggest that late postoperative hemodynamic assessments, as well as early postoperative assessments, are useful for identifying patients at high risk of PVST. A late postoperative hemodynamic assessment may contribute to determining when to discontinue anticoagulants.
METHODS: Eleven patients who underwent left upper lobectomy for lung cancer received 4D flow MRI on postoperative day 7 and again after over 3 months. Hemodynamic parameters were used to classify each case as risky or non-risky for PVST.
RESULTS: According to a total of 24 examinations in 11 patients, 7 were classified as risky and 17 as non-risky. PVST developed in 6 patients during various postoperative phases, and all PVST cases developed under the risky conditions. Furthermore, PVST did not develop under non-risky conditions, suggesting that our risk assessment is valid as a predictive marker for PVST.
CONCLUSION: Our results suggest that late postoperative hemodynamic assessments, as well as early postoperative assessments, are useful for identifying patients at high risk of PVST. A late postoperative hemodynamic assessment may contribute to determining when to discontinue anticoagulants.