Lobar exclusion after transpericardial herniation in a heart-lung transplantation

Lobar herniation is a rare complication of heart-lung transplantation (HLT). We describe a case of right lower lobe herniation through the pericardial window into the left pleural space diagnosed 54 days after operation. Extensive adhesions precluded a lobectomy through a right thoracotomy approach, therefore the lobe was simply excluded and left in situ. The subsequent postoperative course, a CT-scan 2 years later and the 7 years survival time demonstrated that the lobe became fibrosed without any major sequelae.