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

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.

This is a preview of subscription content, log in to check access.

Fig. 1
Fig. 2

References

  1. 1.

    Healey JE Jr.. An anatomic survey of anomalous pulmonary veins: their clinical significance. J Thorac Surg. 1952;23:433–44.

    PubMed  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.

    Article  PubMed  PubMed Central  Google 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.

    Article  PubMed  Google 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.

    Article  PubMed  Google 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.

    Article  CAS  PubMed  Google 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.

  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.

    Article  PubMed  Google 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.

    Article  PubMed  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Yasuhiro Otsuki.

Ethics declarations

Conflict of interest

The authors have no conflict of interest to disclose.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (MPG 3118 KB)

Supplementary material 2 (MPG 41336 KB)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Otsuki, Y., Go, T., Chang, S.S. et al. Anomalous right upper lobe pulmonary veins draining posterior to the pulmonary artery. Gen Thorac Cardiovasc Surg 67, 901–903 (2019). https://doi.org/10.1007/s11748-019-01078-7

Download citation

Keywords

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