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Dual thrombosis of the pulmonary arterial and venous anastomotic sites after single lung transplantation: role of transesophageal echocardiography in diagnosis and management.

Fadel BM, Abdulbaki K, Nambiar V, Al Amri M, Shahid M, Khouqeer F, Canver C

Heart Institute, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. bmfadel@yahoo.com <bmfadel@yahoo.com>

We present the case of a patient who developed severe respiratory and hemodynamic compromise shortly after single right lung transplantation. Transesophageal echocardiography showed a large intraluminal thrombus at the right pulmonary artery anastomosis resulting in severe obstruction to flow together with thrombosis of the right pulmonary veins extending into the left atrium. After thrombectomy and surgical revision of the vascular anastomoses, the patient made an uneventful recovery. This case illustrates the usefulness of transesophageal echocardiography in the diagnosis and treatment of patients who are hemodynamically unstable after lung transplantation.

Published 2 April 2007 in J Am Soc Echocardiogr, 20(4): 438.e9-12.
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