A case of extensive thrombus formation in the left atrium extending from the pulmonary vein resection stump despite anticoagulant therapy after left lower lobectomy: A case report

Abstract

We report a case of extensive asymptomatic thrombus developing from the resection stump of the pulmonary vein after left lower lobectomy, despite continuous anticoagulant therapy. A 67-year-old woman was taking warfarin after valve-replacement surgery. She was introduced to our institution with double cancer comprising cervical and lung cancer. Considering the cancer stages, lung cancer surgery preceded treatment for the cervical cancer. Left lower lobectomy under VATS (video-assisted thoracic surgery) (ND2a-2) was performed (pT1bN2M0), and the patient was discharged without complications. An extensive intraventricular thrombus was confirmed in the left lower pulmonary vein resection stump (with no embolic symptoms) on contrast-enhanced computed tomography of the chest and abdomen before cervical cancer treatment. The thrombus gradually disappeared after starting the continuous intravenous infusion of heparin. Although thrombus formation at the superior pulmonary vein stump has been widely reported after left upper lobectomy, few reports either domestically or abroad have described extensive thrombus formation after lower lobectomy. This case may be very rare, and it is therefore reported.