{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T14:14:41Z","timestamp":1740147281072,"version":"3.37.3"},"reference-count":9,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T00:00:00Z","timestamp":1619568000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T00:00:00Z","timestamp":1619568000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>The median sternotomy approach in sleeve pneumonectomy enables diseased lung ventilation in selected cases, which may reduce the difficulty in achieving anastomosis under intubation of the left main bronchus. However, with median sternotomy, the ascending aorta requires repeated mobilization to expose the operative field for anastomosis, which can cause an aortogenic embolic stroke.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 70-year-old Asian man presenting 6 months after developing hemoptysis was diagnosed with right upper lobe lung cancer (stage T4N0M0), invading the lower trachea and basal bronchus. Preoperative computed tomography revealed ascending aorta calcification. Right sleeve pneumonectomy was performed using median sternotomy with diseased lung ventilation. The ascending aorta was repeatedly mobilized to adequately expose the tracheobronchial bifurcation. Surgery was uneventful, but he did not recover complete consciousness even after termination of anesthesia. Mild paralysis of both upper extremities was observed. Head magnetic resonance imaging on postoperative day 1 revealed multiple small acute infarctions in the brain, possibly caused by mobilization of the aorta. He received anticoagulation therapy and rehabilitation and was discharged on postoperative day 30.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The median sternotomy approach in sleeve pneumonectomy enables diseased lung ventilation. However, the possibility of aortogenic embolic stroke should be considered when calcification of the ascending aorta is observed on preoperative computed tomography.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13256-021-02796-4","type":"journal-article","created":{"date-parts":[[2021,4,27]],"date-time":"2021-04-27T23:10:38Z","timestamp":1619565038000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Aortogenic embolic stroke after sleeve pneumonectomy with median sternotomy for lung cancer: a case report"],"prefix":"10.1186","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6746-3187","authenticated-orcid":false,"given":"Hirotoshi","family":"Suzuki","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masafumi","family":"Noda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatsuaki","family":"Watanabe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasushi","family":"Matsuda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasushi","family":"Hoshikawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshinori","family":"Okada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,4,28]]},"reference":[{"key":"2796_CR1","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1016\/j.jtcvs.2005.07.062","volume":"131","author":"M de Perrot","year":"2006","unstructured":"de Perrot M, Fadel E, Mercier O, Mussot S, Chapelier A, Dartevelle P. Long-term results after carinal resection for carcinoma: does the benefit warrant the risk? J Thorac Cardiovasc Surg. 2006;131:81\u20139.","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2796_CR2","doi-asserted-by":"publisher","first-page":"685","DOI":"10.1016\/S1010-7940(02)00523-7","volume":"22","author":"VA Porhanov","year":"2002","unstructured":"Porhanov VA, Poliakov IS, Selvaschuk AP, Grechishkin AI, Sitnik SD, Nikolaev IF, et al. Indications and results of sleeve carinal resection. Eur J Cardiothorac Surg. 2002;22:685\u201394.","journal-title":"Eur J Cardiothorac Surg"},{"key":"2796_CR3","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1053\/j.semtcvs.2006.05.005","volume":"18","author":"C Aigner","year":"2006","unstructured":"Aigner C, Lang G, Klepetko W. Sleeve pneumonectomy. Semin Thorac Cardiovasc Surg. 2006;18:109\u201313.","journal-title":"Semin Thorac Cardiovasc Surg."},{"key":"2796_CR4","doi-asserted-by":"crossref","unstructured":"Alifano M, Regnard JF. Sleeve pneumonectomy. Multimed Man Cardiothorac Surg. 2007;(507):mmcts.2006.002113.","DOI":"10.1510\/mmcts.2006.002113"},{"key":"2796_CR5","doi-asserted-by":"publisher","first-page":"738","DOI":"10.1253\/circj.CJ-13-1072","volume":"78","author":"JI Shimada","year":"2014","unstructured":"Shimada JI, Yasaka M, Wakugawa Y, Ogata T, Makihara N, Ito S, et al. Features of brain magnetic resonance imaging diffusion-weighted images of aortogenic embolic stroke. Circ J. 2014;78:738\u201342.","journal-title":"Circ J"},{"key":"2796_CR6","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1159\/000347073","volume":"35","author":"Y Shimada","year":"2013","unstructured":"Shimada Y, Ueno Y, Tanaka Y, Okuzumi A, Miyamoto N, Yamashiro K, et al. Aging, aortic arch calcification, and multiple brain infarcts are associated with aortogenic brain embolism. Cerebrovasc Dis. 2013;35:282\u201390.","journal-title":"Cerebrovasc Dis"},{"key":"2796_CR7","doi-asserted-by":"publisher","first-page":"1474","DOI":"10.1056\/NEJM199412013312202","volume":"331","author":"P Amarenco","year":"1994","unstructured":"Amarenco P, Cohen A, Tzourio C, Bertrand B, Hommel M, Besson G, et al. Atherosclerotic disease of the aortic arch and the risk of ischemic stroke. N Eng J Med. 1994;331:1474\u20139.","journal-title":"N Eng J Med"},{"key":"2796_CR8","doi-asserted-by":"publisher","first-page":"2376","DOI":"10.1161\/CIRCULATIONAHA.108.811935","volume":"119","author":"MR Di Tullio","year":"2009","unstructured":"Di Tullio MR, Russo C, Jin Z, Sacco RL, Mohr JP, Homma S. Aortic arch plaques and risk of recurrent stroke and death. Circulation. 2009;119:2376\u201382.","journal-title":"Circulation"},{"key":"2796_CR9","doi-asserted-by":"publisher","first-page":"2470","DOI":"10.1161\/STROKEAHA.107.482497","volume":"38","author":"Y Ueno","year":"2007","unstructured":"Ueno Y, Kimura K, Iguchi Y, Shibazaki K, Inoue T, Hattori N, et al. Mobile aortic plaques are a cause of multiple brain infarcts seen on diffusion-weighted imaging. 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A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"205"}}