Pulmonary vein thrombosis
Pulmonary vein thrombosis is a rare but potentially serious condition that can occur in various situations.
Often the signs and symptoms are nonspecific and can range from being acute (pulmonary infarction) to more insidious (progressive or recurrent pulmonary oedema). Patients may have dyspnoea, haemoptysis, chest pain, fever and/or hypoxaemia.
Pulmonary vein thrombosis can have various cause which include
- intrapulmonary neoplasm - considered most frequent cause 1
- surgical complications of lung transplantation or lobectomy 6
- complication of radiofrequency ablation
- fibrosing mediastinitis
- mitral stenosis with a left atrial clot
- hilar torsion 3
- idiopathic - in hypercoagulable states
Treatment and prognosis
Anticoagulation use is thought to be doubtful in terms of clinical outcome but may avoid clot development in the left atrium and possibly promote recanalisation of the affected pulmonary vein 3.
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- 3. Genta PR, Ho N, Beyruti R et-al. Pulmonary vein thrombosis after bilobectomy and development of collateral circulation. Thorax. 2003;58 (6): 550-1. doi:10.1136/thorax.58.6.550 - Free text at pubmed - Pubmed citation
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- 5. Hovaguimian H, Morris JF, Gately HL et-al. Pulmonary vein thrombosis following bilobectomy. Chest. 1991;99 (6): 1515-6. Pubmed citation
- 5. Selvidge SD, Gavant ML. Idiopathic pulmonary vein thrombosis: detection by CT and MR imaging. AJR Am J Roentgenol. 1999;172 (6): 1639-41. doi:10.2214/ajr.172.6.10350306 - Pubmed citation
- 6. Burri E, Duwe J, Kull C et-al. Pulmonary vein thrombosis after lower lobectomy of the left lung. J Cardiovasc Surg (Torino). 2006;47 (5): 609-12. Pubmed citation
- 7. Alexander GR, Reddi A, Reddy D. Idiopathic pulmonary vein thrombosis: a rare cause of massive hemoptysis. Ann. Thorac. Surg. 2009;88 (1): 281-3. doi:10.1016/j.athoracsur.2008.09.061 - Pubmed citation