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Shifting pneumothorax after heart-lung transplantation.
C E Engeler1, P N Olson, C M Engeler
1Department of Radiology, University of Minnesota Hospital, Minneapolis 55455.
Radiology
|December 1, 1992
Summary
Heart-lung transplants can cause unusual pneumothorax shifts due to open thoracic communication. Radiographs revealed rapid pneumothorax changes and contralateral decompression in transplant patients.
Area of Science:
- Cardiothoracic Surgery
- Pulmonary Medicine
- Radiology
Background:
- Heart-lung transplantation is a complex procedure for end-stage cardiopulmonary failure.
- En bloc heart-lung replacement creates unique thoracic anatomy.
- Potential for abnormal air and fluid dynamics exists post-transplant.
Purpose of the Study:
- To investigate the occurrence of unusual pneumothoraces after heart-lung transplantation.
- To assess if the en bloc nature of the procedure influences pneumothorax dynamics.
Main Methods:
- Retrospective review of chest radiographs from 25 heart-lung transplant recipients.
- Analysis for signs of rapidly changing or unexplained pneumothoraces.
- Comparison with conventional pleural physiology.
Main Results:
- Eight of 25 patients (32%) exhibited unusual pneumothorax behavior.
- Observed phenomena included shifting pneumothoraces and rapid resolution.
- Six patients demonstrated contralateral chest tube decompression of pneumothorax.
Conclusions:
- Heart-lung transplantation can lead to atypical pneumothorax dynamics.
- The en bloc nature of the surgery may facilitate air/fluid shifts.
- Contralateral decompression via chest tubes is a notable finding.