Pulmonary vein thrombosis (PVT) is a potentially fatal complication following
lung transplantation (LT). The clinical presentation of PVT is nonspecific and mimics other common
postoperative complications such as
reperfusion injury,
infection, and rejection.
Transesophageal echocardiography (TEE)
plays a pivotal
role in detecting
abnormalities of the pulmonary venous anastomosis in the
perioperative period. Echocardiographic findings that warrant concern include a visible
thrombus in
pulmonary vein,
pulmonary vein diameter <5mm, turbulence on
color Doppler, and peak systolic velocity >100 cm/s.
Transplant centers should strongly considerTEE in individual
patients with unexplained
graft failure.