POSTOPERATIVE STATUS
The patient’s postoperative course included thrombocytopenia, with a corresponding negative heparin-induced thrombocytopenia assay, and atrial fibrillation managed with amiodarone. She was started on warfarin with a target INR of 2.0-3.0. Postoperative echocardiography demonstrated left ventricular ejection fraction of 45-50%, right ventricular volume and pressure overload, moderately reduced right ventricular systolic function, and mild mitral and tricuspid regurgitation. She was discharged home on the 14thpostoperative day.
The patient has been recovering well. She has completed a postoperative, five-week course of adjuvant external radiation for the microscopic positive margins, delivered as 60 Gy in 25 fractions. Follow-up chest, abdomen, and pelvis CT have suggested no new or progressive disease in the chest or metastases. She is alive and free from tumor recurrence at one year postoperatively.