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Donor Posterior Atrial Flap Rotation for Left Atrial Cuff Reconstruction in Lung Transplantation
Published on: October 11, 2024
Lobar torsion after lung transplantation
Mong-Wei Lin1, Shu-Chien Huang, Shuenn-Wen Kuo
1Department of Surgery, National Taiwan University Hospital Yun-Lin Branch, Douliu City, Yunlin, Taiwan.
Journal of the Formosan Medical Association = Taiwan Yi Zhi
|February 6, 2013
Summary
Right middle lobe torsion is a rare complication following lung transplantation. This case highlights the diagnostic and management challenges of this serious condition in lung transplant recipients.
Area of Science:
- Thoracic Surgery
- Transplantation Medicine
- Pulmonary Medicine
Background:
- Bilateral sequential lung transplantation (BLTx) is a life-saving procedure for end-stage lung diseases.
- Complications after lung transplantation can be severe and impact patient outcomes.
- Lobar torsion, though rare, is a potential post-transplant complication requiring prompt recognition.
Observation:
- A 30-year-old female developed right middle lobe (RML) infiltrates post-BLTx for bronchiolitis obliterans.
- Clinical signs of infection (fever, leukocytosis) emerged one week post-surgery.
- Chest computed tomography confirmed RML torsion, necessitating RML lobectomy.
Findings:
- The patient experienced acute respiratory distress syndrome (ARDS) with hemodynamic instability and severe hypoxemia post-lobectomy.
- Venoarterial extracorporeal membrane oxygenation (VA-ECMO) was initiated for life support.
- Successful recovery and discharge occurred 5 months after the initial BLTx.
Implications:
- This case underscores the importance of considering lobar torsion in lung transplant recipients with persistent infiltrates and signs of sepsis.
- Early diagnosis via imaging and prompt surgical intervention are crucial for managing RML torsion.
- Advanced life support, including VA-ECMO, may be necessary for critically ill patients with post-transplant complications.
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