Embolic Stroke due to Pulmonary Vein Thrombosis: A Late Complication of Lung Transplantation

Pulmonary vein thrombosis (PVT) is a rare condition seen almost exclusively in the first two weeks after lung transplantation or lobectomy. Subsequent embolic phenomena are uncommon. Herein, a 47-year-old male with a history of bilateral lung transplantation presented with transient episodes of acute dysphasia and right arm weakness. Brain MRI revealed cortical infarcts in the territory of the left middle cerebral artery. Transesophageal echocardiogram demonstrated a thrombus in the left lower pulmonary vein. This represents the latest manifestation of a PVT reported in the literature—6 years after redo transplantation and 13 years after the original surgery. Investigation for PVT should be considered in any patient with previous lung transplantation that presents with systemic emboli.