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Pulmonary vein thrombosis after bilobectomy and development of collateral circulation

Division of Respiratory Diseases, Heart Institute (InCor), University of São Paulo School of Medicine, São Paulo, Brazil

Correspondence to:
Correspondence to:
Dr P R Genta, Rua General Mena Barreto 616, São Paulo, SP, CEP 01433-010, Brazil;
prgenta{at}usp.br

ABSTRACT
Pulmonary vein thrombosis is a rare but potentially life threatening complication following lobectomy or bilobectomy. We present a case of right upper pulmonary vein thrombosis after a middle and lower lobectomy diagnosed at transoesophageal echocardiography. The patient was treated with antibiotics and anticoagulation with good recovery. Pulmonary angiography was performed 35 days after surgery and revealed the venous return of the right lung through the intercostal veins. Despite double venous drainage of the lungs consisting of bronchial and pulmonary veins, pulmonary to systemic collaterals following pulmonary vein thrombosis have not previously been reported. The development of this shunt can prevent gangrene, and surgical resection of the lung segment involved can be avoided.

Keywords: pulmonary vein thrombosis; collateral circulation; angiography

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