A network of pulmonary vein thrombi is a risk factor for ischemic stroke, especially after cardiac surgery: A case report and mini review

• Main Author: Hidekazu Takeuchi
• Format: Article
• Language: English
• Published: Elsevier 2015-03-01
• Series: International Journal of Cardiology: Heart & Vasculature
• Subjects: Ischemic stroke; Cardiac surgery; Pulmonary vein thrombi; Dabigatran; 64-MDCT
• Online Access: http://www.sciencedirect.com/science/article/pii/S2352906714000888

Stroke remains a devastating complication following cardiac surgery. Pulmonary vein thrombi (PVT) are believed to be rare, but I have reported 37 cases of PVT in elderly patients with chest pain since 2012, indicating that PVT are not unusual. The present case showed that PVT can make a network among four pulmonary veins and left atrium. Currently, PVT are not recognized as a risk factor for ischemic stroke, especially following cardiac surgery. A 76-year-old male was examined by 64-slice multidetector CT (64-MDCT) to assess chest pain. The 64-MDCT scan revealed thrombi in the left upper and lower pulmonary veins, the right upper and lower pulmonary veins and the left atrium (LA) as the defects of contrast enhancements. The LA thrombi seemed to be connected to PVT forming a network of thrombi. To avoid stroke following cardiac surgery, it is important to cope with PVT. How to treat PVT during cardiac surgery should be developed.