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Muñoz Fos A, Cerezo Madueño F, Cosano J, Redel J, González García J, Poveda D, Ruíz E, Moreno Casado P, Algar Algar J, Álvarez Kindelan A, Baamonde Laborda C, Salvatierra Velázquez Á. Early Surgical Management of Bronchial Dehiscence After Single-Lung Transplantation: A Case Report. Transplant Proc 2020; 52:596-598. [PMID: 32061425 DOI: 10.1016/j.transproceed.2019.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 09/03/2019] [Indexed: 11/26/2022]
Abstract
Anastomotic airway complications after lung transplantation affect up to 20% of patients. Bronchial stenosis is the most frequent complication, while dehiscence of bronchial anastomosis is a rarely seen complication, with report incidences between 1% and 10%. Despite its low incidence, dehiscence of bronchial anastomoses remains a disastrous complication in the posttransplantation period without a well-established management protocol. We present a challenging case of complete bronchial dehiscence after unilateral lung transplantation in a patient with interstitial lung fibrosis (ILF) that occurred on postoperative day 10. The dehiscence was diagnosed early and the patient's status was stable for repeat thoracotomy, therefore, an early surgical approach was preferable to conservative management or bronchoscopy. Aggressive early surgical management in a stable patient allows for complete debridement with removal of the detritus that impedes correct anastomosis healing and permits the removal of microbial vegetations with successful results.
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Affiliation(s)
- Anna Muñoz Fos
- Division of Thoracic Surgery and Lung Transplantation, Reina Sofia University Hospital, Córdoba, Spain.
| | - Francisco Cerezo Madueño
- Division of Thoracic Surgery and Lung Transplantation, Reina Sofia University Hospital, Córdoba, Spain
| | - Javier Cosano
- Division of Interventional Pneumology, Reina Sofia University Hospital, Córdoba, Spain
| | - Javier Redel
- Division of Interventional Pneumology, Reina Sofia University Hospital, Córdoba, Spain
| | - Javier González García
- Division of Thoracic Surgery and Lung Transplantation, Reina Sofia University Hospital, Córdoba, Spain
| | - David Poveda
- Division of Thoracic Surgery and Lung Transplantation, Reina Sofia University Hospital, Córdoba, Spain
| | - Eloísa Ruíz
- Division of Thoracic Surgery and Lung Transplantation, Reina Sofia University Hospital, Córdoba, Spain
| | - Paula Moreno Casado
- Division of Thoracic Surgery and Lung Transplantation, Reina Sofia University Hospital, Córdoba, Spain
| | - Javier Algar Algar
- Division of Thoracic Surgery and Lung Transplantation, Reina Sofia University Hospital, Córdoba, Spain
| | - Antonio Álvarez Kindelan
- Division of Thoracic Surgery and Lung Transplantation, Reina Sofia University Hospital, Córdoba, Spain
| | - Carlos Baamonde Laborda
- Division of Thoracic Surgery and Lung Transplantation, Reina Sofia University Hospital, Córdoba, Spain
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Makey IA, Johnson SB. Keep it short and sweet. J Thorac Cardiovasc Surg 2018; 156:e33. [PMID: 29724599 DOI: 10.1016/j.jtcvs.2018.03.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Accepted: 03/28/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Ian A Makey
- Department of Cardiothoracic Surgery, Mayo Clinic, Jacksonville, Fla
| | - Scott B Johnson
- Department of Cardiothoracic Surgery, UT Health San Antonio, San Antonio, Tex.
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