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Case Report
4D flow MRI as a preoperative assessment tool for patients undergoing lobectomy for partial anomalous pulmonary venous return
1 Thoracic and Breast Surgery, Iwata City Hospital, 512-3, Ohkubo, Iwata, Shizuoka 438-8550, Japan
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Takashi Yamashita
Head of Department, Thoracic and Breast Surgery, Iwata City Hospital, 512- 3, Ohkubo, Iwata, Shizuoka 438-8550,
Japan
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Article ID: 101392Z01TY2023
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Yamashita T, Mochizuki T. 4D flow MRI as a preoperative assessment tool for patients undergoing lobectomy for partial anomalous pulmonary venous return. Int J Case Rep Images 2023;14(1):99–102.ABSTRACT
Introduction: Partial anomalous pulmonary venous return is a congenital malformation. The abnormal pulmonary to systemic blood flow ratio may affect general anesthesia. Therefore, it is important to figure out pulmonary to systemic blood flow ratio before surgery.
Case Report: A 62-year-old man was referred to our hospital. Close examination of a patient suspected with right upper lobe lung cancer revealed partial anomalous pulmonary venous return in the same lobe. Generally, if partial anomalous pulmonary venous return is present in the lung lobe to be resected, surgery can be performed as planned. However, we performed 4D flow magnetic resonance imaging (MRI) to evaluate pulmonary to systemic blood flow ratio for safer anesthesia and surgery. His pulmonary to systemic blood flow ratio was 1.04, which seemed safe for general anesthesia and surgery. Right upper lobectomy was performed, and the patient was discharged on postoperative day 7 without any circulatory complications.
Conclusion: We found that 4D flow MRI contributed to a safe perioperative management and it must be meaningful for partial anomalous pulmonary venous return in the other lobe.
Keywords: Four-dimensional flow magnetic resonance imaging, Lobectomy, Partial anomalous pulmonary venous return, Pulmonary to systemic blood flow ratio
SUPPORTING INFORMATION
Acknowledgments
I would like to thank Masaki Terada, a chief engineer of Division of Radiology Diagnostic Technology, for technical assistance with the experimental measurements.
Author ContributionsTakashi Yamashita - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Takahiro Mochizuki - Acquisition of data, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2023 Takashi Yamashita et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
