Bilateral lung transplant with pulmonary thromboendarterectomy for Eisenmenger's syndrome

Patients with secondary pulmonary hypertension frequently present for evaluation for lung transplantation. In some of these patients, Eisenmenger's syndrome has developed from chronic left to right intracardiac shunts. A smaller group of these patients will also have associated pulmonary artery aneurysms. There is a paucity of literature discussing this topic, however, and currents reports have suggested the need to replace the abnormal pulmonary artery. This paper discusses a patient in whom Eisenmenger's syndrome developed from an atrial septal defect, and resultant pulmonary artery aneurysms and mural thrombi, who underwent successful bilateral lung transplantation with thromboendarterectomy and atrial septal defect closure.