SPONTANEOUS RESOLUTION OF PULMONARY VENOUS THROMBOSIS AFTER LUNG TRANSPLANTATION

Thrombus formation at the pulmonary venous anastomotic site after lung transplantation may have catastrophic consequences, including allogra ft failure and stroke. However, treatment with systemic anticoagulatio n may facilitate bleeding in the early postoperative period. In the pr esent report, we describe the clinical and transesophageal echocardiog raphic findings of pulmonary venous thrombosis in two patients in the immediate postoperative period after lung transplantation. Treatment w ith systemic anticoagulation was not feasible because of extensive pos toperative thoracic bleeding in each instance. A conservative approach was taken on the basis of the small size of each thrombus and lack of accelerated flow velocity at the site of the thrombus. Each thrombus resolved spontaneously without clinical sequelae. These two cases sugg est that thrombus size and flow velocity at the anastomotic site may b e used to guide the clinical management of pulmonary venous thrombosis after lung transplantation.