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Anomalous right upper lobe pulmonary veins draining posterior to the pulmonary artery

  • Yasuhiro OtsukiEmail author
  • Tetsuhiko Go
  • Sung Soo Chang
  • Natsumi Matsuura
  • Hiroyasu Yokomise
Case Report

Abstract

The anatomy of pulmonary vessels varies. The right upper pulmonary vein usually drains in front of the pulmonary artery to the left atrium. We herein describe a case of the right upper lobe pulmonary vein draining posterior to the pulmonary artery and absent right upper lobe pulmonary vein in the ventral hilum. A 64-year-old woman suspected to have lung cancer and scheduled for surgery underwent pre-operative three-dimensional computed tomography (3D-CT), which revealed that pulmonary vessels V1 + 3 and V2 drain posteriorly to the pulmonary artery. Video-assisted right upper lobectomy was performed because the patient was diagnosed with lung adenocarcinoma through intraoperative pathologic analysis, and all the pulmonary vessels were identified correctly during the operation. Despite the limited surgical field of video-assisted lobectomy, the operation was performed safely because the pre-operative 3D-CT assessment revealed the anatomy of the anomalous pulmonary vessels, helping us avoid missing any anomaly and vessel injury.

Keywords

Anomalous pulmonary vein Three-dimensional computed tomography Video-assisted thoracotomy Lung cancer 

Notes

Compliance with ethical standards

Conflict of interest

The authors have no conflict of interest to disclose.

Supplementary material

Supplementary material 1 (MPG 3118 KB)

Supplementary material 2 (MPG 41336 KB)

References

  1. 1.
    Healey JE Jr.. An anatomic survey of anomalous pulmonary veins: their clinical significance. J Thorac Surg. 1952;23:433–44.Google Scholar
  2. 2.
    Shimizu K, Nagashma T, Ohtaki Y, Obayashi K, Nakazawa S, Kamiyoshihara M, et al. Analysis of the variation pattern in right upper pulmonaryveins and establishment of simplified vein models for anatomical segmentectomy. Gen Thorac Cardiovasc Surg. 2016;64:604–11.CrossRefGoogle Scholar
  3. 3.
    Asai K, Urabe N, Yajima K, Suzuki K, Kazui T. Right upper lobe venous drainage posterior to the bronchus intermedius: preoperative identification by computed tomography. Ann Thorac Surg. 2005;79:1866–71.CrossRefGoogle Scholar
  4. 4.
    Kurihara N, Saito H, Usami S, Imai K, Konno H, Atari M, et al. Lung cancer surgery in partial anomalous pulmonary venous connection patients. Ann Thorac Surg. 2018;105:e7–9.CrossRefGoogle Scholar
  5. 5.
    Yurugi Y, Nakamura H, Taniguchi Y, Miwa K, Fujioka S, Haruki T, et al. Case of thoracoscopic right upper lobectomy for lung cancer with tracheal bronchus and a pulmonary vein variation. Asian J Endosc Surg. 2012;5:93–5.CrossRefGoogle Scholar
  6. 6.
    Ichiki Y, Kakizoe K, Hamatsu T, Suehiro T, Koike M, Tanaka F, et al. A rare anomaly of the right superior pulmonary vein: report of a case. 2017;38:26–28.Google Scholar
  7. 7.
    Yamada S, Suga A, Inoue Y, Iwazaki M. Importance of preoperative assessment of pulmonary venous anomaly for safe video-assisted lobectomy. Interact Cardiovasc Thorac Surg. 2010;10:851–4.CrossRefGoogle Scholar
  8. 8.
    Hagiwara M, Shimada Y, Kato Y, Nawa K, Makino Y, Furumoto H, et al. High-quality 3-dimensional image simulation for pulmonary lobectomy and segmentectomy: results of preoperative assessment of pulmonary vessels and short-term surgical outcomes in consecutive patients undergoing video-assisted thoracic surgerydagger. Eur J Cardiothorac Surg. 2014;46:e120–6.CrossRefGoogle Scholar

Copyright information

© The Japanese Association for Thoracic Surgery 2019

Authors and Affiliations

  • Yasuhiro Otsuki
    • 1
    Email author
  • Tetsuhiko Go
    • 1
  • Sung Soo Chang
    • 1
  • Natsumi Matsuura
    • 1
  • Hiroyasu Yokomise
    • 1
  1. 1.Department of General Thoracic, Breast and Endocrine Surgery, Faculty of MedicineKagawa UniversityKagawaJapan

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