Infantile lobar emphysema in association with congenital heart disease

Three cases of congenital heart disease (CHD) are presented; all infants developed the unusual complication of lobar emphysema (LE). In all cases delay in reaching the correct diagnosis resulted in two of the infants undergoing a second operation to resect the emphysematous lobe. The chest radiograph in all cases was dominated by the heart disease and the radiological signs of LE were initially missed. The radionuclide ventilation/perfusion lung scan was used in two of these infants to provide conclusive proof and to emphasise the clinical significance of the condition. Lobar emphysema in association with CHD should be recognised early and lobectomy performed at the same time as surgical correction of the heart defect.