Lobectomy for Lung Cancer With Partial Anomalous Pulmonary Venous Connection in a Different Lobe: A Case Report

A 78-year-old man was diagnosed with right middle lobe lung cancer, complicated by partial anomalous pulmonary venous connection (PAPVC) in the right upper lobe pulmonary vein. After right middle lobe resection, there was concern about the risk of right heart failure (RHF) due to increased right and left shunting. A pulmonary artery occlusion test using a right heart catheter determined the pulmonary systemic blood flow ratio to be 1.30; the predicted value after the right middle lobectomy was 1.51. The risk of developing RHF after lobectomy was predicted to be low. Therefore, a thoracoscopic right middle lobectomy was performed without PAPVC repair; RHF did not occur postoperatively. Recognizing the presence of PAPVC preoperatively and predicting postoperative hemodynamics when performing lung resection in a patient with PAPVC in the unresected lung are both crucial to avoid fatal postoperative RHF.