Format

Send to

Choose Destination
Case Rep Pulmonol. 2016;2016:9575894. doi: 10.1155/2016/9575894. Epub 2016 Dec 26.

Postpneumonectomy Compression of the Mitral Annulus: Rare Vascular Complication in Sportive Patient.

Author information

1
Unité de Physiologie Respiratoire et Sportive, CHU de Rouen, 76031 Rouen, France.
2
Service de Pneumologie, CHU de Rouen, 76031 Rouen, France.
3
Service de Chirurgie Vasculaire et Thoracique, CHU de Rouen, 76031 Rouen, France.
4
Service de Cardiologie, CHU de Rouen, 76031 Rouen, France.
5
Service de Radiologie, CHU de Rouen, 76031 Rouen, France.
6
ADIR Association, Hôpital de Bois-Guillaume, 76230 Bois-Guillaume, France.
7
Unité de Physiologie Respiratoire et Sportive, CHU de Rouen, 76031 Rouen, France; ADIR Association, Hôpital de Bois-Guillaume, 76230 Bois-Guillaume, France; UPRES, EA 3830, GRHV, Faculté de Médecine, 76183 Rouen Cedex, France.
8
CETAPS, EA 3832, UFR STAPS, Université de Rouen, 76821 Mont Saint Aignan, France.

Abstract

Numerous postpneumonectomy complications exist. We present a rare clinical case of postpneumonectomy exertional dyspnea revealing compression of the mitral annulus by the descending aorta. The patient was 42-year-old former smoker with pulmonary emphysema. He has been operated on, in 2012 (i.e., right pneumonectomy). Before the surgery, the patient was a recreational runner. However, after some months, it was difficult for the patient to resume running. Cardiopulmonary exercise testing indicated moderate exercise intolerance with important oxygen desaturation. More interestingly, a decrease of low oxygen pulse was noticed from the first ventilatory threshold with no electrical modification on the electrocardiogram. This decrease was indicative of a decline in stroke volume. The thoracic scan revealed a right pneumonectomy pocket with a liquid abnormal content. Moreover, the mediastinum had shifted toward the pneumonectomy space and the left lung was distended and emphysematous. Echocardiography revealed a major change in the mediastinal anatomy. The mitral annulus was observed to be compressed by the rear wall of the descending aorta. The diagnosis of postpneumonectomy syndrome or platypnea-orthodeoxia syndrome was ruled out in this patient. Mitral annular compression by the descending aorta is rare complication, which must be researched in patients with postpneumonectomy exertional dyspnea.

Supplemental Content

Full text links

Icon for Hindawi Limited Icon for PubMed Central
Loading ...
Support Center