[Successful second stage operations for bilateral giant bullae with cardiovascular disease by thoracotomy and...

A 65-year-old male was admitted to our hospital because of bilateral giant bullae and right side pneumothorax. He had had a myocardial infarction and had been receiving medications. Considering his age, ischemic heart disease and hypertension, we excised the bullae in two operations. The first operation was open chest bullectomy of a giant bulla and small bulla on the right side. After this procedure, his clinical course was uneventful. In the second operation, thoracoscopic excision of the left side giant bulla was performed using only one endoscopic stapler by rotating each side of the bulla and making a clear excision line between the bulla and normal lung. His post operative course was excellent and he was discharged from our hospital on the 15th day after the second operation.