Cardiovascular Computed Tomography Findings after Pneumonectomy: Comparison to Lobectomy

To identify and compare cardiovascular findings on computed tomography (CT) scans after pneumonectomy (PNX) with those after lobectomy (LOBX).

Pre- and postoperative CT scans from 25 PNX patients were retrospectively analyzed and compared to those from 30 LOBX patients. The diameter of the main pulmonary artery (PA) and its ratio to the ascending aorta (PA/Ao) were determined. Cardiac morphometry values were ascertained by measuring maximum diameters of the right and left ventricle on axial (RV_axial, LV_axial) and four-chamber (RV_4-ch, LV_4-ch) views. RV_axial/LV_axial and RV_4-ch/LV_4-ch ratios were calculated. Vessel stumps were evaluated for thrombosis.

After PNX, PA (31.1 ± 5.8 mm vs 28.7 ± 5.4 mm, P = 0.003), PA/Ao (0.97 ± 0.15 vs 0.86 ± 0.12, P = 0.0001), and cardiac morphometry values significantly increased (RV_axial 43.6 ± 7.4 vs 39.4 ± 7.1, P = 0.029; RV_4-ch 41.1 ± 6.3 vs 37.6 ± 5.7, P = 0.041; RV_axial/LV_axial 1.18 ± 0.27 vs 1.03 ± 0.22, P = 0.04; RV_4-ch/LV_4-ch 1.17 ± 0.21 vs 1.02 ± 0.16, P = 0.03). There were no significant differences between right and left PNX. One case of PA stump thrombosis was identified after right PNX. LOBX resulted in a significant increase in PA (30.6 ± 4.3 vs 28.7 ± 3.5, P = 0.005) and PA/Ao (0.90 ± 0.09 vs 0.85 ± 0.10, P = 0.017), whereas cardiac morphometry values were not significantly changed compared to baseline values. No vessel stump thrombosis was observed after LOBX. In comparison to LOBX, all ascertained values were significantly elevated after PNX.

Morphologic alterations of the cardiovascular system following PNX can be identified on CT scans. Alterations are more distinct after PNX compared to LOBX.