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General Thoracic and Cardiovascular Surgery
Published in: General Thoracic and Cardiovascular Surgery 5/2019

01-05-2019 | Original Article

Ligating the pulmonary vein at the pericardial reflection is useful for preventing thrombus formation in the pulmonary vein stump after left upper lobectomy

Authors: Takahito Nakano, Hiroyuki Kaneda, Takayuki Kawaura, Tomoki Kitawaki, Tomohiro Murakawa

Published in: General Thoracic and Cardiovascular Surgery | Issue 5/2019

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Abstract

Objectives

Thrombus formation in the pulmonary vein stump after left upper lobectomy is supposedly a risk factor for systemic thrombosis, resulting in a critical course for the patient. The purpose of this study was to assess the efficacy of the proximal ligation method preventing thrombus formation and thrombosis comparing the two groups of patients (those who did and those who did not undergo pulmonary vein ligation).

Methods

We performed a surgical procedure to shorten the pulmonary vein stump in the left upper lobectomy. In this procedure, we first dissected the pericardium from the left upper pulmonary vein, and then we ligated the pulmonary vein at the pericardial reflection before stapling transection.

Results

In the group that was not treated with the proximal ligation method, thrombus formation in the pulmonary vein stump was detected in all four cases. In contrast, thrombus formation in the pulmonary vein stump was detected in one only case of the eight cases treated with the proximal ligation method, which was significantly fewer than among those not treated with the ligation method (p = 0.010). The logistic regression analysis revealed in both the univariate (p = 0.0014) and multivariate analyses (p = 0.0071) that the proximal ligation method was significantly associated with reduced thrombus formation in the pulmonary vein stump.

Conclusions

Thrombus formation in the pulmonary vein stump was significantly reduced by ligating the pulmonary vein at the pericardial reflection.
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Metadata
Title
Ligating the pulmonary vein at the pericardial reflection is useful for preventing thrombus formation in the pulmonary vein stump after left upper lobectomy
Authors
Takahito Nakano
Hiroyuki Kaneda
Takayuki Kawaura
Tomoki Kitawaki
Tomohiro Murakawa
Publication date
01-05-2019
Publisher
Springer Singapore
Published in
General Thoracic and Cardiovascular Surgery / Issue 5/2019
Print ISSN: 1863-6705
Electronic ISSN: 1863-6713
DOI
https://doi.org/10.1007/s11748-018-1032-9

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