CTICasesPost-Operative Unilateral Pulmonary Edema from Left Pulmonary Venous Thrombosis
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Imaging findings
Pre-operative imaging showed a right aortic arch, aberrant subclavian and innominate arteries, a large left vertical vein draining the entire left lung into the subclavian vein (no left pulmonary veins), and a non-restricted cor triatriatum sinister. Post-operatively, there was acute, striking asymmetric consolidation with air bronchograms and septal thickening in the left lung. Pulmonary arteries were patent, but there was no opacification of any left pulmonary veins, indicating thrombosis of the reimplanted vein.
Key takeaways
Unilateral pulmonary edema post-surgery, especially after attempts to correct congenital anomalies, should prompt suspicion of venous obstruction. Imaging demonstrates striking asymmetric consolidation and lack of venous opacification. Pre-operative knowledge of complex anatomy is crucial.
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