Lung Lobectomy Is an Embolic Risk Factor for Cerebral Infarction, Even in the Long-term Postoperative Phase

Intern Med. 2023 Nov 15;62(22):3401-3404. doi: 10.2169/internalmedicine.1529-22. Epub 2023 Apr 7.

Abstract

The vein stump created after lung lobectomy has been reported to cause thrombus and subsequently cerebral infarction. However, its assessment after a long-term postoperative course remains unreported. The pulmonary vein stump is a structure near the left atrial appendage; therefore, such patients may be at a constant risk of thrombus formation. We herein report two cases of cerebral infarction associated with lung lobectomy. Transesophageal echocardiography revealed mobile thrombi in the pulmonary vein stump. Both patients had cancer recurrence, and hypercoagulability may have contributed to thrombus formation. This vein stump should be investigated as an embolic source, even after a long postoperative duration.

Keywords: cerebral infarction; embolism; lung lobectomy; pulmonary vein stump; stroke.

MeSH terms

  • Cerebral Infarction / complications
  • Cerebral Infarction / etiology
  • Echocardiography, Transesophageal
  • Embolism* / complications
  • Humans
  • Lung
  • Lung Neoplasms* / complications
  • Lung Neoplasms* / diagnostic imaging
  • Lung Neoplasms* / surgery
  • Neoplasm Recurrence, Local / complications
  • Pneumonectomy / adverse effects
  • Risk Factors
  • Thrombosis* / complications
  • Venous Thrombosis* / etiology