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

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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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Authors and Affiliations

  1. Division of Thoracic Surgery, Kansai Medical University Medical Center, 10-15 Fumizonocho, Moriguchishi, Osaka, 570-8507, Japan

    Takahito Nakano & Hiroyuki Kaneda

  2. Department of Thoracic Surgery, Kansai Medical University, Hirakatashi, Japan

    Takahito Nakano, Hiroyuki Kaneda & Tomohiro Murakawa

  3. Department of Mathematics, Kansai Medical University, Hirakatashi, Japan

    Takayuki Kawaura & Tomoki Kitawaki

Authors
  1. Takahito Nakano
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  2. Hiroyuki Kaneda
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  3. Takayuki Kawaura
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  4. Tomoki Kitawaki
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  5. Tomohiro Murakawa
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Corresponding author

Correspondence to Hiroyuki Kaneda.

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The authors have declared that no conflict of interest exists.

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Nakano, T., Kaneda, H., Kawaura, T. et al. Ligating the pulmonary vein at the pericardial reflection is useful for preventing thrombus formation in the pulmonary vein stump after left upper lobectomy. Gen Thorac Cardiovasc Surg 67, 450–456 (2019). https://doi.org/10.1007/s11748-018-1032-9

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  • DOI: https://doi.org/10.1007/s11748-018-1032-9

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