Acute Management of Infected Chronic Thromboembolic Disease

Publication date: October 2018Source: The Annals of Thoracic Surgery, Volume 106, Issue 4Author(s): Donna May Kimmaliardjuk, Carole Dennie, Sean Dickie, Eric C. Belanger, Fraser RubensA 29-year-old man with chronic pulmonary emboli presented to the hospital with progressive pleuritic chest pain. He was in acute right ventricular failure and received intrapulmonary arterial tissue plasminogen activator. Massive hemoptysis developed, requiring emergent thromboendarterectomy. A clot was visualized in the main left pulmonary artery that had formed a bronchovascular fistula into the left upper lobe bronchus. Pathology of the clot revealed fibrinopurulent exudate and Gram-positive cocci. The left pulmonary artery was repaired with a pericardial patch, and the left upper lobe was oversewn with subsequent left upper lobectomy. The patient was discharged home on postoperative day 23.
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research