Contralateral pulmonary embolism caused by pulmonary artery stump thrombosis after pneumonectomy

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.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / pathology
  • Adenocarcinoma / surgery*
  • Aged
  • Angiography / methods
  • Anticoagulants / therapeutic use
  • Atrial Fibrillation / diagnostic imaging
  • Atrial Fibrillation / drug therapy
  • Contrast Media
  • Follow-Up Studies
  • Humans
  • Lung Neoplasms / pathology
  • Lung Neoplasms / surgery*
  • Male
  • Neoplasm, Residual / complications*
  • Pleural Effusion / diagnosis
  • Pleural Effusion / etiology
  • Pneumonectomy / adverse effects
  • Pneumonectomy / methods*
  • Pulmonary Embolism / diagnostic imaging
  • Pulmonary Embolism / drug therapy*
  • Pulmonary Embolism / etiology*
  • Risk Assessment
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome
  • Ultrasonography, Doppler / methods


  • Anticoagulants
  • Contrast Media