Native lung volume reduction surgery relieves functional graft compression after single- lung transplantation for chronic obstructive pulmonary disease

Slides:

Advertisements

Similar presentations

The value of ventilation scintigraphy after single lung transplantation Jan Paul Ouwens, MD, Wim van der Bij, MD, PhD, Thomas W van der Mark, MD, PhD,

Advertisements

Max B. Mitchell, MD The Journal of Thoracic and Cardiovascular Surgery

Two decades of pediatric lung transplant in the United States: Have we improved? Farhan Zafar, MD, Jeffrey S. Heinle, MD, Marc G. Schecter, MD, Joseph.

Timothy L. Van Natta, MD, Mark D. Iannettoni, MD, MBA

Effect of volume reduction on lung transplant timing and selection for chronic obstructive pulmonary disease Joseph E. Bavaria, MD, Alberto Pochettino,

Lobar lung transplantation: One size fits all

Endovascular treatment of a combined pseudoaneurysm and arteriovenous fistula of the subclavian artery caused by a gunshot wound to the chest Fausto.

Yesterday's heroic measure is now standard procedure: Extracorporeal membrane oxygenation as a bridge to lung transplant Victor van Berkel, MD, PhD

Lung transplantation with donation after cardiac death donors: Long-term follow-up in a single center Nilto C. De Oliveira, MD, Satoru Osaki, MD, PhD,

Improving health care by embracing Systems Theory

Adult Bochdalek hernia complicated with a perforated colon

Right internal thoracic artery or saphenous vein grafting

Extended pericardiotomy avoids cardiopulmonary bypass during bilateral sequential lung transplantation Takahiro Oto, MD, Marc Rabinov, FRACS, Franklin.

Centers for Disease Control “increased-risk” organ donor: Not so risky? Francis D. Pagani, MD, PhD The Journal of Thoracic and Cardiovascular Surgery

Defining operative mortality: Impact on outcome reporting

Steven R. DeMeester, MD. , G. Alexander Patterson, MD, R

Repair of sternal dehiscence after bilateral lung transplantation

The Journal of Thoracic and Cardiovascular Surgery

Marye J. Gleva, MD, Charles B. Huddleston, MD

How should we treat air leaks?

Harold L. Lazar, MD The Journal of Thoracic and Cardiovascular Surgery

New treatment approaches create new disease processes: A short guide on how to reduce unexpected events to a minimum Martin Czerny, MD, MBA The Journal.

Quadruple valve replacement in patients with carcinoid heart disease

Abbas Emaminia, MD, Sara A

Safety and efficacy of median sternotomy versus video-assisted thoracic surgery for lung volume reduction surgery The Journal of Thoracic and Cardiovascular.

Bilateral lung transplantation and pulmonary artery reconstruction in a patient with chronic obstructive pulmonary disease and a giant pulmonary artery.

Metastasectomy in a lung graft using high-flow venovenous extracorporeal lung support in a patient after single lung transplantation Bassam Redwan, MD,

Aditya K. Kaza, MD The Journal of Thoracic and Cardiovascular Surgery

Comparative study of bronchial artery revascularization in lung transplantation Gösta B. Pettersson, MD, PhD, Karam Karam, MD, Lucy Thuita, MS, Douglas.

Successful pediatric single-lung transplantation with previous contralateral pneumonectomy, using controlled “donation after cardiac death” lung, for.

It's not “just a shunt” but sometimes it should be…

Fixing the supply problem

Bartley P. Griffith, MD, FACS, FRCS

Experience from an American Association for Thoracic Surgery Foundation for Thoracic Surgery Training Fellowship: Lung transplantation in Toronto General.

A first start for lung transplantation?

The evolution of intraoperative support in lung transplantation: Cardiopulmonary bypass to extracorporeal membrane oxygenation P. Michael McFadden, MD,

Third-time lung transplantation in a patient with cystic fibrosis

Joseph A. Dearani, MD, Michael J. Ackerman, MD, PhD

Chronic obstructive pulmonary disease severity influences outcomes after off-pump coronary artery bypass Benjamin Medalion, MD, Michael G. Katz, MD,

Daniel Kreisel, MD, PhD, Alexander S

Daniel T. Engelman, MD, FACS, Michael J. Germain, MD

A fate worse than death Jennifer S. Lawton, MD

Attachment disorder in thoracoabdominal surgery

The Ross procedure: Time to reevaluate the guidelines

Taking UP the chronic pulmonary obstructive disease gauntlet

Passing the torch The Journal of Thoracic and Cardiovascular Surgery

Robert James Cerfolio, MD, FACS, FCCP, Ayesha S. Bryant, MSPH, MD

T. Brett Reece, MD The Journal of Thoracic and Cardiovascular Surgery

The harder one looks, the more one finds

The origins of open heart surgery at the University of Minnesota 1951 to 1956 Richard A. DeWall, MD The Journal of Thoracic and Cardiovascular Surgery

Bryan M. Burt, MD The Journal of Thoracic and Cardiovascular Surgery

Bilateral versus single lung transplantation for chronic obstructive pulmonary disease: intermediate-term results Alberto Pochettino, MD, Robert M Kotloff,

Jeffrey H. Shuhaiber, MD, Jeff Moore, MS, David B. Dyke, MD

The Journal of Thoracic and Cardiovascular Surgery

Discussion The Journal of Thoracic and Cardiovascular Surgery

The future of cardiac surgery training: A survival guide

Commentary: Doing what is right—We are all in this together

“The more things change…”: The challenges ahead

Managing conflicts of interest

First in line for robotic surgery: Would you want to know?

More than vital: Who bears the burden?

Apples remain apples NO matter what

Respect the aorta The Journal of Thoracic and Cardiovascular Surgery

Preoperative PFTs: The answer is blowing in the wind

The evolution of cardiothoracic critical care

Of mice and men… The Journal of Thoracic and Cardiovascular Surgery

Commentary: Evaluation of primary graft dysfunction after lung transplantation—It is time to teach an old dog new tricks! W. Hampton Gray, MD, P. Michael.

Descending thoracic and thoracoabdominal aortic aneurysms: “Busted”

Edward Y. Chan, MD, Michael J. Reardon, MD

Zone zero thoracic endovascular aortic repair is all about “location, location, location” Kevin L. Greason, MD The Journal of Thoracic and Cardiovascular.

Presentation transcript:

Native lung volume reduction surgery relieves functional graft compression after single- lung transplantation for chronic obstructive pulmonary disease T. Brett Reece, MD, John D. Mitchell, MD, Martin R. Zamora, MD, David A. Fullerton, MD, Joseph C. Cleveland, MD, Marvin Pomerantz, MD, Dennis M. Lyu, MD, Frederick L. Grover, MD, Michael J. Weyant, MD The Journal of Thoracic and Cardiovascular Surgery Volume 135, Issue 4, Pages 931-937 (April 2008) DOI: 10.1016/j.jtcvs.2007.10.069 Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Evolution of graft compression on chest radiographic analysis. These plain films show the progression of graft compression with increased right lung volume and mediastinal shift from after transplantation to before lung volume reduction surgery (LVRS). The last film demonstrates resolution of the compression after LVRS. The Journal of Thoracic and Cardiovascular Surgery 2008 135, 931-937DOI: (10.1016/j.jtcvs.2007.10.069) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Algorithm for lung volume reduction surgery (LVRS) after single-lung transplantation for chronic obstructive pulmonary disease. The steps for working up a decrease in pulmonary function in single-lung transplantation for chronic obstructive pulmonary disease are shown. native lung hyperinflation (NLH) is a diagnosis of exclusion, and therefore every attempt is made to exclude infection, acute rejection, and bronchiolitis obliterans syndrome (BOS). The workup, in bold, includes findings and reasons for the test. FEV1, Forced expiratory volume in 1 second; CXR, chest radiography; VQ, ventilation/perfusion. The Journal of Thoracic and Cardiovascular Surgery 2008 135, 931-937DOI: (10.1016/j.jtcvs.2007.10.069) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Changes in forced expiratory volume in 1 second (FEV1). The graft depicts individual changes in FEV1 from after transplantation to after LVRS by each patient. On average, there was significant improvement, and all but 1 of the hospital survivors demonstrated benefit on the basis of FEV1 from the procedure. The mean FEV1 at each point is depicted by the thick gray line with the diamond markers. ∗Significant change from after transplantation and after lung volume reduction surgery (LVRS; P < .01). The Journal of Thoracic and Cardiovascular Surgery 2008 135, 931-937DOI: (10.1016/j.jtcvs.2007.10.069) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Changes in pulmonary function: A, changes in 6-minute walk values; B, changes in room air oxygen saturation. These 2 graphs show the respective changes in mean distance during 6-minute walks and room air oxygen from after transplantation through the clinical native lung hyperinflation to after lung volume reduction surgery (LVRS). Both markers of clinical pulmonary function showed a decrease from peak after transplantation, which was recovered to baseline in the majority of patients within 6 months of LVRS. ∗Significant change from after transplantation and after LVRS, P < .01). The Journal of Thoracic and Cardiovascular Surgery 2008 135, 931-937DOI: (10.1016/j.jtcvs.2007.10.069) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions