title: Late complications. Late respiratory failure.
abstract: Late and progressive respiratory failure after pneumonectomy may result from a variety of causes. Non-specific causes include restrictive failure by loss of alveolar volume; pulmonary hypertension; initial disease recurrence (e.g. bronchogenic cancer, bronchiectasis); side-effects of radio- and chemotherapy; and benign or malignant pleural or pericardial effusions. Acute or subacute conditions are congestive or ischemic heart failure, pulmonary embolism, and pneumonia. Two causes are specific, benign, and curable: the postpnemonectomy syndrome and the platypneaorthodeoxia syndrome. The latter is related to a right-to-left interatrial shunt through a reopened patent foramen ovale. The hemodynamic and anatomical mechanisms are analyzed through an exhaustive review of the literature, together with the particular clinical presentation and the easy diagnosis if suspected.
authors.affiliation: Department of Thoracic Surgery, Hôpitaux Universitaires de Strasbourg, France. Jean-Marie.Wihlm@chru-strasbourg.fr
authors.forename: J M
authors.initials: JM
authors.lastname: Wihlm
authors.forename: G
authors.initials: G
authors.lastname: Massard
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects; D001987:Bronchiectasis / Q000150:complications; D002283:Carcinoma, Bronchogenic / Q000150:complications; D018450:Disease Progression; D006333:Heart Failure / Q000150:complications; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications; D017202:Myocardial Ischemia / Q000150:complications; D009364:Neoplasm Recurrence, Local / Q000150:complications; D010490:Pericardial Effusion / Q000150:complications; D010996:Pleural Effusion / Q000150:complications; D011013:Pneumonectomy / Q000009:adverse effects*; D011014:Pneumonia / Q000150:complications; D011650:Pulmonary Alveoli / Q000503:physiopathology; D011655:Pulmonary Embolism / Q000150:complications; D011878:Radiotherapy / Q000009:adverse effects; D012008:Recurrence; D012131:Respiratory Insufficiency / Q000209:etiology*; D013997:Time Factors
chemical_list: D000970:Antineoplastic Agents