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.