Multicenter Randomized Trial to Prevent Pulmonary Vein Stump Thrombus After Left-Sided Anatomical Lung Resection

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Medical Imaging

Background:

• Pulmonary vein stump thrombosis (PVST) is common after left-sided anatomical pulmonary resection.
• Floating thrombi in pulmonary vein stumps can cause systemic embolic complications like cerebral infarction.
• There is a need for improved postoperative outcomes in general thoracic surgery.

Purpose of the Study:

• To confirm the efficacy of postoperative heparin in preventing PVST after left-sided anatomical pulmonary resection.
• To assess the impact of heparin on reducing postoperative cerebral infarction.
• To evaluate the incidence of systemic thromboembolic events.

Main Methods:

• A randomized trial involving 250 patients from 26 institutions.
• Focus on left-sided anatomical pulmonary resections.
• Primary endpoint: PVST frequency on CT scans at postoperative day 5 ± 2.
• Secondary endpoint: Systemic thromboembolic events, including cerebral infarction.

Main Results:

• The PV STUDY (Postoperative heparin administration to prevent pulmonary vein stump thrombus after left side anatomical pulmonary resection: Multicenter Randomized Phase II trial) opened in October 2024.
• Trial registration is ongoing.
• Primary analysis is scheduled for spring 2027.

Conclusions:

• The study is designed to provide crucial data on heparin's role in preventing PVST.
• Findings are expected to inform clinical practice for patients undergoing pulmonary resection.
• The research aims to reduce postoperative complications and improve patient outcomes.