A rare case of right pulmonary segmental artery dissection following pacemaker insertion

Description

This paper describes a case of pulmonary segmental artery dissection following pacemaker insertion. The patient was admitted electively and was clinically well prior to admission. The patient had a history of factor V Leiden disease, trifascicular heart block and ischaemic heart disease. The pacemaker was inserted successfully under general anaesthesia.

At day 0 after the operation, the patient was diagnosed with a left leg deep venous thrombosis. Given the high-risk patient factor of developing pulmonary embolism (PE), a CT pulmonary angiogram (CTPA) was performed. No PE was diagnosed; instead, the CTPA discovered a focal dissection flap that originated from the right lower lobe segmental artery, extending into the subsegmental branches craniocaudally for 3 cm (figure 1, figure 2 and figure 3). The CTPA was reviewed by a consultant radiologist. The patient remained asymptomatic. Subsequent discussions with the cardiothoracic surgical team concluded that...

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