Catheter fragmentation and local lysis in two lung transplant patients with pulmonary embolism

Pulmonary Transplant Salvage Using Ultrasound-Assisted Thrombolysis of Subacute Occlusive Main Pulmonary Artery Embolus

A 53-year-old woman who underwent bilateral lung transplantation 14 months before presented with 2 to 3 weeks of severe exertional dyspnea. Workup revealed a complete embolic occlusion of her left main pulmonary artery related to a femoral deep venous thrombosis. The occlusion did not respond to systemic anticoagulation, and a trial of catheter-directed thrombolysis was pursued. Flow to the left lower lobe was restored after 2 days of thromobolytic therapy. The patient is alive and well at more than 1 year of follow-up.

Single Lung Retransplantation for Graft Infarction due to Herniation of Heart

A young woman with terminal respiratory failure due to idiopathic pulmonary hypertension underwent bilateral lung transplantation. The postoperative course was complicated by herniation of the heart through over the cut pericardial edge on left side leading to left-sided graft infarction requiring pneumonectomy. Unable to wean off mechanical ventilation, patient required lobar transplantation on the left side.