Atrial anastomotic thrombus causes neurologic deficits in a lung transplant recipient.

Abstract:

:Pulmonary thrombus formation in the region of atrial anastomosis following lung transplantation has been reported by several authors. Such patients typically present immediately after surgery with significant hemodynamic compromise causing pulmonary edema and hypoxemia. We describe a patient who presented with bilateral neurologic deficits 4 and 6 weeks after lung transplantation. Despite a normal transthoracic echocardiogram, transesophageal echocardiography (TEE) detected a large left atrial thrombus adherent to the atrial anastomosis. This thrombus was treated with intravenous heparin and subsequently warfarin. After 3 weeks, a repeat TEE demonstrated complete resolution of the lesion. This case demonstrates that postoperative left atrial and pulmonary venous thrombi may provide the basis for serious patient morbidity without hemodynamic or radiographic clues to their presence, that TEE is superior to transthoracic echocardiography for detecting left atrial thrombi, and that such lesions can respond to medical management alone.

journal_name

Transplantation

journal_title

Transplantation

authors

Stang MR,Hinderliter AL,Gott KK,Paradowski LJ,Aris RM

doi

10.1097/00007890-199609150-00028

subject

Has Abstract

pub_date

1996-09-15 00:00:00

pages

693-5

issue

5

eissn

0041-1337

issn

1534-6080

journal_volume

62

pub_type

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