Minimally invasive repair of post-pneumonectomy syndrome

We report on a 42-year-old female who underwent right pneumonectomy for hemoptysis from an aspergilloma cavity. Several years postoperatively she complained of increasing shortness of breath, wheezing, and dyspnea upon exertion. Chest computed tomography showed a counterclockwise rotation of the mediastinum with obstruction of the left lower lobe bronchus. Minimally invasive repair was carried out using an intrapleural tissue expander for dissection and an adjustable saline prosthesis for mediastinal centralization. Intraoperative bronchoscopy showed complete resolution of the left lower lobe bronchial obstruction, and postoperatively her symptoms resolved completely. This is the first reported case of a minimally invasive approach for the treatment of post-pneumonectomy syndrome in the United States.