Delayed Chest Closure Assessed by Transesophageal Echocardiogram in Single-Lobe Lung Transplantation Fengshi Chen, MD, Shino Matsukawa, MD, Hisanari.

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Presentation transcript:

Delayed Chest Closure Assessed by Transesophageal Echocardiogram in Single-Lobe Lung Transplantation Fengshi Chen, MD, Shino Matsukawa, MD, Hisanari Ishii, MD, Tadashi Ikeda, MD, Tsuyoshi Shoji, MD, Takuji Fujinaga, MD, Toru Bando, MD, Hiroshi Date, MD The Annals of Thoracic Surgery Volume 92, Issue 6, Pages 2254-2257 (December 2011) DOI: 10.1016/j.athoracsur.2011.05.102 Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Chest roentgenogram of a 6-year-old girl with idiopathic interstitial pneumonia on admission. The Annals of Thoracic Surgery 2011 92, 2254-2257DOI: (10.1016/j.athoracsur.2011.05.102) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 The trend of perioperative three-dimensional (3D) computed tomographic (CT) volumetry. (A) Lateral view (upper 3 panels) and (B) anterior view (lower three panels). 3D-CT volumetry can visualize size matching between the donor and the recipient. Preoperative 3D-CT volumetry indicated the recipient’s right chest cavity volume to be only 552 ml. The evaluated volume of the mother’s right lower lobe was 1,142 ml, indicating the graft would be 207% bigger than the right chest cavity of the recipient. Postoperative 3D-CT volumetry showed that the implanted graft volume was 632 ml, which was 55.2% of its original size. The Annals of Thoracic Surgery 2011 92, 2254-2257DOI: (10.1016/j.athoracsur.2011.05.102) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Evaluation of the right pulmonary venous (PV) anastomosis by transesophageal echocardiogram (TEE). (A) The TEE demonstrated that the PV anastomosis was stenotic under a positive end-expiratory pressure (PEEP) of 5 cm H2O. (B) After reduction of the PEEP to 3 cm H2O, the patency of PV anastomosis improved. (C) On the next day after lung transplantation, the chest was closed completely and the PV anastomosis was wide open. The Annals of Thoracic Surgery 2011 92, 2254-2257DOI: (10.1016/j.athoracsur.2011.05.102) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Chest roentgenogram of the recipient 3 months after the living-donor right single-lobe lung transplantation. The Annals of Thoracic Surgery 2011 92, 2254-2257DOI: (10.1016/j.athoracsur.2011.05.102) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions