Obstructive Shock Due to a Crushed Left Atrium and Pulmonary Vein by Pulmonary Artery Intimal Sarcoma Successfully Treated with Pulmonary Vein Stenting

Shoichiro Furukawa; Keita Inanaga; Toshihiro Osaki; Manabu Yasuda; Yasuhiro Ohga; Yoshihiro Ohishi; Takashi Matsumoto; Takayuki Uchida; Shujiro Inoue

doi:10.2169/internalmedicine.1487-22

CASE REPORTS

Obstructive Shock Due to a Crushed Left Atrium and Pulmonary Vein by Pulmonary Artery Intimal Sarcoma Successfully Treated with Pulmonary Vein Stenting

Shoichiro Furukawa, Keita Inanaga, Toshihiro Osaki, Manabu Yasuda, Yasuhiro Ohga, Yoshihiro Ohishi, Takashi Matsumoto, Takayuki Uchida, Shujiro Inoue

Author information

Shoichiro Furukawa
Department of Cardiology, Aso Iizuka Hospital, Japan
Keita Inanaga
Department of Cardiology, Aso Iizuka Hospital, Japan
Toshihiro Osaki
Department of Thoracic Surgery, Kokura Memorial Hospital, Japan
Manabu Yasuda
Department of Thoracic Surgery, Aso Iizuka Hospital, Japan
Yasuhiro Ohga
Department of Cardiology, Aso Iizuka Hospital, Japan
Yoshihiro Ohishi
Department of Pathology, Aso Iizuka Hospital, Japan
Takashi Matsumoto
Department of Cardiovascular Surgery, Aso Iizuka Hospital, Japan
Takayuki Uchida
Department of Cardiovascular Surgery, Aso Iizuka Hospital, Japan
Shujiro Inoue
Department of Cardiology, Aso Iizuka Hospital, Japan

Keywords: obstructive shock, postpneumonectomy, pulmonary artery intimal sarcoma, pulmonary vein stenosis, pulmonary vein stenting, venoarterial extracorporeal membrane oxygenation

JOURNAL OPEN ACCESS
Supplementary material

2024 Volume 63 Issue 2 Pages 247-252

DOI https://doi.org/10.2169/internalmedicine.1487-22

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Abstract

A 46-year-old patient who had undergone right pneumonectomy for pulmonary artery intimal sarcoma presented with hypoxemia. The recurrent sarcoma in the mediastinum revealed external compression to the left pulmonary veins (PVs), leading to obstructive shock and cardiac arrest. Venous artery extracorporeal membrane oxygenation (VA-ECMO) was initiated; however, withdrawal was difficult, and the patient's survival seemed hopeless. However, the patient's condition improved with stenting for the compressed PV; therefore, VA-ECMO was discontinued, and he was discharged on foot. This is the first case report of obstructive shock due to critical PV stenosis caused by compression of a malignant tumor that responded to PV stenting.

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