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Frequency and management of pneumothoraces in heart-lung transplant recipients
D V Paranjpe1, G R Wittich, L W Hamid
1Department of Radiology, Stanford University Medical Center, Calif.
Purpose:
To determine the frequency and describe the clinical relevance of simultaneous bilateral pneumothoraces in heart-lung transplant recipients.
Materials And Methods:
The chest radiographs in 72 consecutive heart-lung transplant recipients were retrospectively reviewed. The study group consisted of 15 patients with a pneumothorax that occurred after removal of surgically placed drainage tubes and subsequent complete expansion of both lungs.
Results:
Simultaneous bilateral pneumothoraces occurred in six patients (40%); 10 episodes of unilateral pneumothorax occurred in nine patients (60%). Causes of pneumothoraces included transthoracic fine-needle biopsy (n = 5), bronchoscopic biopsy (n = 3), placement of a central venous catheter (n = 3), and thoracentesis (n = 3); no cause was found in two cases.
Conclusion:
Physicians who perform transthoracic interventions in this patient population should be aware of the likelihood of persistent pleural communications and the possibility of potentially life-threatening bilateral pneumothoraces.