title: Pulmonary artery stenosis shortly after lung transplantation: successful balloon dilation and stent insertion in one case.
abstract: BACKGROUND
  Pulmonary artery stenosis after lung transplantation is a rare complication. It usually requires surgical correction but even after that the outcome is not favorable.<br />
  
  
  METHODS
  The patient was a 53-years-old woman who was candidate for lung transplantation surgery due to pulmonary fibrosis. After 7 months on waiting list, with severe limitations in daily living activities, she received a single lung transplant in 2007. The surgery was performed without any complication. One day after surgery and after extubation, the patient needed oxygen supplementation through mask with reservoir bag. In bronchoscopy, black-and-white exudate and black membrane that blocked the main bronchus in the transplanted lung was observed. By bronchial lavage the membrane and exudate were successfully removed and patient received antibiotics for documented Aspergillus infection and methylprednisolone pulse therapy for evidences of graft rejection. Despite success in treatments of the mentioned complications, the condition of the patient deteriorated and she became totally dependent to supplemental oxygen. Oxygen consumption level had increase and pulmonary artery pressure was increasing gradually. With suspicion to pulmonary artery stenosis, bronchial CT-Scan with contrast was performed 13 days after transplantation surgery which showed a 50% stenosis. Trans-esophageal echocardiography also showed a stenosis with 40 mmHg gradient. 18 days after transplantation surgery, percutaneous balloon angioplasty was performed which was initially successful but re-stenosis occurred. Seven days later, another balloon angioplasty with stent insertion was performed. After the procedure, the gradient has been removed. Patient was discharged 30 days after transplantation. Follow-up after 10 months revealed no stenosis and the stent was working properly.<br />
  
  
  CONCLUSIONS
  Stent angioplasty can be performed with no problem or complication if pulmonary artery stenosis is seen after lung transplantation.<br /> <br />
authors.affiliation: Lung transplantation Research Center, National Research Institute of Tuberclosis and lung Disease, Shaheed Beheshti Medical Sciences University, Tehran, Iran. katynajafi@gmail.com
authors.forename: Katayoun
authors.initials: K
authors.lastname: Najafizadeh
authors.forename: Abolghasem
authors.initials: A
authors.lastname: Daneshvar
authors.forename: Azizollah Abbasi
authors.initials: AA
authors.lastname: Dezfouli
authors.forename: Babak Sharif
authors.initials: BS
authors.lastname: Kashani
authors.forename: Zargham Hossein
authors.initials: ZH
authors.lastname: Ahmadi
authors.forename: Mohammad Behgam
authors.initials: MB
authors.lastname: Shadmehr
authors.forename: Masoud
authors.initials: M
authors.lastname: Ghasemi
authors.forename: Babak
authors.initials: B
authors.lastname: Kardavani
authors.forename: Maryam Moghani
authors.initials: MM
authors.lastname: Lankarani
authors.forename: Shadi
authors.initials: S
authors.lastname: Shafaghi
mesh_terms: D000800:Angioplasty, Balloon; D005260:Female; D006801:Humans; D016040:Lung Transplantation / Q000009:adverse effects*; D008875:Middle Aged; D011183:Postoperative Complications / Q000628:therapy; D011651:Pulmonary Artery / Q000473:pathology*; D011658:Pulmonary Fibrosis / Q000601:surgery; D012008:Recurrence; D015607:Stents