A case of adenocarcinoma of the lung complicated with chronic thromboembolic pulmonary hypertension that underwent upper pulmonary lobectomy

Yuichiro Mima, Keisuke Miyamoto, Hirofumi Kamata, Daisuke Taniyama, Masahiro Kaji, Fumio Sakamaki

Research output: Contribution to journalArticle

Abstract

Background. Pulmonary hypertension is a known risk factor of perioperative complications, but the risks of non-cardiac operations have not been examined sufficiently. Case. A 68-year-old man was found to have chronic thromboembolic pulmonary hypertension and adenocarcinoma of the upper lobe of the left lung. Anticoagulation therapy was started and video-assisted thoracoscopic left upper lobectomy was performed on the lung carcinoma because of thrombi in the pulmonary artery trunk had disappeared, together with reduced pulmonary arterial pressure (PAP) on cardiac echography. After anesthesia, severe pulmonary hypertension (mean PAP > 40 mmHg) became obvious on right heart catheterization. Following surgery, pulmonary hypertension continued, and anticoagulation and combination therapy with sildenafil and bosentan was started. Exercise tolerance improved and the patient was discharged under long-term oxygen therapy 30 days after the operation. Conclusion. Sildenafil and bosentan were effective for pulmonary hypertension after pulmonary lobectomy. Further research with a large-scale study is recommended.

Original languageEnglish
Pages (from-to)1023-1029
Number of pages7
JournalJapanese Journal of Lung Cancer
Volume52
Issue number7
DOIs
Publication statusPublished - 2012 Dec
Externally publishedYes

Fingerprint

Pulmonary Hypertension
Lung
Arterial Pressure
Exercise Tolerance
Cardiac Catheterization
Pulmonary Artery
Ultrasonography
Thrombosis
Therapeutics
Anesthesia
Adenocarcinoma of lung
Oxygen
Carcinoma
Research
Sildenafil Citrate
bosentan

Keywords

  • Bosentan
  • Chronic thromboembolic pulmonary hypertension
  • Lung cancer
  • Pulmonary lobectomy
  • Sildenafil

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine

Cite this

A case of adenocarcinoma of the lung complicated with chronic thromboembolic pulmonary hypertension that underwent upper pulmonary lobectomy. / Mima, Yuichiro; Miyamoto, Keisuke; Kamata, Hirofumi; Taniyama, Daisuke; Kaji, Masahiro; Sakamaki, Fumio.

In: Japanese Journal of Lung Cancer, Vol. 52, No. 7, 12.2012, p. 1023-1029.

Research output: Contribution to journalArticle

Mima, Yuichiro ; Miyamoto, Keisuke ; Kamata, Hirofumi ; Taniyama, Daisuke ; Kaji, Masahiro ; Sakamaki, Fumio. / A case of adenocarcinoma of the lung complicated with chronic thromboembolic pulmonary hypertension that underwent upper pulmonary lobectomy. In: Japanese Journal of Lung Cancer. 2012 ; Vol. 52, No. 7. pp. 1023-1029.
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AU - Kaji, Masahiro

AU - Sakamaki, Fumio

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AB - Background. Pulmonary hypertension is a known risk factor of perioperative complications, but the risks of non-cardiac operations have not been examined sufficiently. Case. A 68-year-old man was found to have chronic thromboembolic pulmonary hypertension and adenocarcinoma of the upper lobe of the left lung. Anticoagulation therapy was started and video-assisted thoracoscopic left upper lobectomy was performed on the lung carcinoma because of thrombi in the pulmonary artery trunk had disappeared, together with reduced pulmonary arterial pressure (PAP) on cardiac echography. After anesthesia, severe pulmonary hypertension (mean PAP > 40 mmHg) became obvious on right heart catheterization. Following surgery, pulmonary hypertension continued, and anticoagulation and combination therapy with sildenafil and bosentan was started. Exercise tolerance improved and the patient was discharged under long-term oxygen therapy 30 days after the operation. Conclusion. Sildenafil and bosentan were effective for pulmonary hypertension after pulmonary lobectomy. Further research with a large-scale study is recommended.

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