Thoracoscopic native lung pneumonectomy after single lung transplant: initial experience with 2 cases†

Eur J Cardiothorac Surg. 2016 Jan;49(1):352-4. doi: 10.1093/ejcts/ezv075. Epub 2015 Mar 1.

Abstract

Single lung transplants (SLTs) leave in place a diseased lung, a potential source of complications. Native lung pneumonectomy is occasionally indicated. We present 2 cases of native lung complications (NLCs) managed with video-assisted thoracoscopic surgery (VATS) pneumonectomy at our institution, a procedure never reported in this context before. Case 1 involves a 59-year old gentleman with refractory, invasive pulmonary aspergillosis of the native lung, 5 years after SLT for idiopathic pulmonary fibrosis. Case 2 involves a 66-year old gentleman with α-1 antitrypsin deficiency who developed severe haemoptysis and intraparenchymal haemorrhage in the native lung 12 years after SLT. A VATS pneumonectomy was performed in both cases because we believed it would facilitate wound healing and hasten recovery in immunosuppressed patients. Our short-term results align with this hypothesis. We conclude that VATS pneumonectomy is a feasible, adequate and safe procedure in this patient population; larger series are needed to draw definitive conclusions.

Keywords: Experimental thoracic surgery; Lung—other.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Feasibility Studies
  • Hemoptysis / etiology
  • Hemoptysis / surgery
  • Humans
  • Lung Transplantation / adverse effects*
  • Lung Transplantation / methods
  • Male
  • Middle Aged
  • Pneumonectomy / methods*
  • Pulmonary Aspergillosis / diagnostic imaging
  • Pulmonary Aspergillosis / surgery
  • Pulmonary Fibrosis / surgery
  • Thoracic Surgery, Video-Assisted / methods*
  • Tomography, X-Ray Computed
  • alpha 1-Antitrypsin Deficiency / surgery

Supplementary concepts

  • alpha-1-Antitrypsin Deficiency, Autosomal Recessive