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Ann Thorac Surg 2009;88:2011-2013. doi:10.1016/j.athoracsur.2009.04.082
© 2009 The Society of Thoracic Surgeons
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Case Reports

Unusual Presentation of a Complication After Pulmonary Wedge Resection for Coccidioma

François Leduc, BSc PTa, Seng Thipphavong, MDa,b, Fred Matzinger, MDa,b,*, Carole Dennie, MDa,b, Sudhir Sundaresan, MDa,c

a Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
b Department of Diagnostic Imaging, The Ottawa Hospital, Ottawa, Ontario, Canada
c Department of Thoracic Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada

Accepted for publication April 15, 2009.

* Address correspondence to Dr Matzinger, Department of Diagnostic Imaging, The Ottawa Hospital, General Campus, 501 Smyth Rd, Ottawa, Ontario, K1H 8L6, Canada (Email: fmatzinger{at}ottawahospital.on.ca).

We report an unusual presentation of a complication after pulmonary wedge resection. A patient with a history of pulmonary wedge resection for coccidioma presented postoperatively with dyspnea and severe hypoxemia. Cerebral infarctions were diagnosed less than 1 year later. Cardiac magnetic resonance imaging and pulmonary angiogram revealed a pulmonary arteriovenous fistula. Surgical resection of the pulmonary arteriovenous fistula led to improved oxygen saturation and discontinuation of home oxygen.




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