Sarah Cullivan, MD, Karen Redmond, MD, Carole Ridge, MD, Oisin J

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Presentation transcript:

Interventional Procedures in Patients With Pulmonary Vascular Obstruction Sarah Cullivan, MD, Karen Redmond, MD, Carole Ridge, MD, Oisin J. O’Connell, MD The Annals of Thoracic Surgery Volume 107, Issue 1, Pages e9-e11 (January 2019) DOI: 10.1016/j.athoracsur.2018.05.024 Copyright © 2019 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 In a 21-year-old woman presenting with progressive dyspnea after double-lung transplantation, the chest roentgenogram shows right parenchymal infiltrates. The Annals of Thoracic Surgery 2019 107, e9-e11DOI: (10.1016/j.athoracsur.2018.05.024) Copyright © 2019 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Contrast-enhanced axial computed tomographic images demonstrate the following: (A) a right hilar soft tissue attenuation mass (arrowhead) invading the right pulmonary vein and left atrium; (B) multiple enlarged right paratracheal lymph nodes (arrowheads) and extensive chest wall collateral veins (arrows) secondary to superior vena cava occlusion; (C) clustered right upper lobe nodules with perilesional ground-glass opacity (arrow) and marked subpleural sparing (arrowheads) likely reflecting normal pleural lymphatic drainage but impaired peribronchovascular lymphatic drainage; and (D) smooth interlobular septal lines and nodular ground-glass opacity in the right lung base (arrows); the asymmetric pattern is likely reflective of unilateral pulmonary venous obstruction. The Annals of Thoracic Surgery 2019 107, e9-e11DOI: (10.1016/j.athoracsur.2018.05.024) Copyright © 2019 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Contrast-enhanced axial computed tomographic images. (A) Right upper lobe nodules with surrounding ground-glass attenuation, suggestive of angioinvasive aspergillosis or pulmonary venous infarction. (B) Improvement is demonstrated 2 months after the initiation of antifungal therapy. (C) Right lower lobe interlobular septal thickening and a small pleural effusion that (D) is markedly improved at 2 months. The Annals of Thoracic Surgery 2019 107, e9-e11DOI: (10.1016/j.athoracsur.2018.05.024) Copyright © 2019 The Society of Thoracic Surgeons Terms and Conditions