[Diffuse bronchomalacia after double lung transplantation. Thoughts apropos of a case].
A 40 year old woman suffered from respiratory insufficiency (arterial PaO2 = 47 mmHg) because of a chronic beryllium intoxication. On 6th June 1990, she underwent double lung transplantation with cardio-pulmonary bypass. Each lung was separately implanted via an extra-pericardial approach, and both bronchi were anastomosed at the hilum. On the seventh post operative day, a severe bilateral bronchial ischemia was noticed (black mucosa). Few weeks later, a diffuse bronchomalacia was noticed in the proximal and distal parts of both bronchial trees. To our knowledge, such a bronchial post-ischemic complication has never been reported. The explantation could be several added causes: imperfect preservation of the lung during harvesting, post operative pulmonary oedema, and operative use of an antifibrinolytic agent (aprotinin).
Brichon
P Y
PY
Service de Chirurgie thoracique, CHU Grenoble.
Blin
D
D
Noirclerc
M
M
Magne
J L
JL
Blanc Jouvan
F
F
Pison
C
C
Romand
P
P
Brambilla
E
E
Barnoud
D
D
Farah
I
I
D000328:Adult; D001607:Berylliosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D001980:Bronchi / Q000098:blood supply / Q000473:pathology; D001982:Bronchial Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000382:microbiology / Q000473:pathology; D002177:Candidiasis / Q000150:complications; D005260:Female; D006801:Humans; D007511:Ischemia / Q000150:complications; D016040:Lung Transplantation / Q000009:adverse effects* / Q000379:methods; D009336:Necrosis; D011183:Postoperative Complications; D011300:Preoperative Care; D011859:Radiography; D012131:Respiratory Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D013203:Staphylococcal Infections / Q000150:complications / Q000382:microbiology
Bronchomalacie diffuse après greffe pulmonaire bilatérale. Réflexions à propos d'un cas.