Right lower lung midline herniation as a rare complication in an infant with heart-lung transplantation: A case report.
case report
heart-lung transplantation
infant
lung herniation
organ transplantation
Journal
Pediatric transplantation
ISSN: 1399-3046
Titre abrégé: Pediatr Transplant
Pays: Denmark
ID NLM: 9802574
Informations de publication
Date de publication:
20 Nov 2023
20 Nov 2023
Historique:
revised:
06
11
2023
received:
06
10
2023
accepted:
09
11
2023
medline:
21
11
2023
pubmed:
21
11
2023
entrez:
20
11
2023
Statut:
aheadofprint
Résumé
Lung herniation is a rare complication of heart-lung transplantation that can be fatal owing to vascular compromise and airway obstruction. To date, only five cases of lung herniation related to heart-lung transplantation have been reported in the literature; however, to the best of our knowledge, this is the first worldwide report of heart-lung transplantation-related lung herniation in an infant. We describe the case of lung herniation as a rare heart-lung transplantation-related complication in an infant. A 12-month-old female baby developed severe bronchopulmonary dysplasia with severe pulmonary hypertension, and she underwent extracorporeal membrane oxygenation for cardiac collapse and lung support. Then, we performed heart-lung transplantation to manage the irreversible deterioration of her lung function. After the heart-lung transplantation, we found the radiological abnormalities persisted on follow-up chest radiographs until the 13th postoperative day diagnosed as lung herniation of the right lower lobe on chest computed tomography. After the relocation of the herniated lung, the clinical condition of the patient improved, and the patient is currently growing without any respiratory symptoms. In this case report, we emphasize that clinical awareness and high suspicion of this rare complication are needed for early diagnosis and proper treatment to prevent post-transplantation morbidity and mortality related to potential ischemic injury.
Sections du résumé
BACKGROUND
BACKGROUND
Lung herniation is a rare complication of heart-lung transplantation that can be fatal owing to vascular compromise and airway obstruction. To date, only five cases of lung herniation related to heart-lung transplantation have been reported in the literature; however, to the best of our knowledge, this is the first worldwide report of heart-lung transplantation-related lung herniation in an infant.
METHODS
METHODS
We describe the case of lung herniation as a rare heart-lung transplantation-related complication in an infant. A 12-month-old female baby developed severe bronchopulmonary dysplasia with severe pulmonary hypertension, and she underwent extracorporeal membrane oxygenation for cardiac collapse and lung support. Then, we performed heart-lung transplantation to manage the irreversible deterioration of her lung function. After the heart-lung transplantation, we found the radiological abnormalities persisted on follow-up chest radiographs until the 13th postoperative day diagnosed as lung herniation of the right lower lobe on chest computed tomography.
RESULTS
RESULTS
After the relocation of the herniated lung, the clinical condition of the patient improved, and the patient is currently growing without any respiratory symptoms.
CONCLUSIONS
CONCLUSIONS
In this case report, we emphasize that clinical awareness and high suspicion of this rare complication are needed for early diagnosis and proper treatment to prevent post-transplantation morbidity and mortality related to potential ischemic injury.
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
e14656Informations de copyright
© 2023 Wiley Periodicals LLC.
Références
Baldwin JC. Technique of combined heart-lung transplantation. J Card Surg. 1992;7:313-323. doi:10.1111/j.1540-8191.1992.tb01021.x
Jamieson SW, Stinson EB, Oyer PE, Baldwin JC, Shumway NE. Operative technique for heart-lung transplantation. J Thorac Cardiovasc Surg. 1984;87:930-935.
Dartevelle P, Vouhé P, Macchiarini P, Chapelier A. Technique of heart-lung transplantation. In: Patterson GA, Couraud L, eds. Lung Transplantation, Current Topics in General Thoracic Surgery, an International Series. Vol 3. Elsevier; 1995:235-246.
Goodman LR. Postoperative chest radiograph: II. Alterations after major intrathoracic surgery. AJR Am J Roentgenol. 1980;134:803-813. doi:10.2214/ajr.134.4.803
Katzberg RW, Whitehouse GH, deWeese JA. The early radiologic findings in the adult chest after cardiopulmonary bypass surgery. Cardiovasc Radiol. 1978;1:205-215. doi:10.1007/BF02552045
Chiles C, Guthaner DF, Jamieson SW, Stinson EB, Oyer PE, Silverman JF. Heart-lung transplantation: the postoperative chest radiograph. Radiology. 1985;154:299-304. doi:10.1148/radiology.154.2.3917571
Jougon J, Duffy J, Delaisement C, Velly JF. Lobar exclusion after transpericardial herniation in a heart-lung transplantation. Eur J Cardiothorac Surg. 1997;12:919-921. doi:10.1016/s1010-7940(97)00279-0
Yonan NA, Egan J, Deiraniya AK, Rahman AN. Right lower lobe herniation after domino heart-lung transplantation. Ann Thorac Surg. 1995;59:1223-1226. doi:10.1016/0003-4975(94)00883-9
Genevois PA, Antoine M, Yernault JC, Leclerc JC, Estenne M. Dextroposition of the left lower lobe after heart-lung transplantation. Chest. 1993;103:1910-1912. doi:10.1378/chest.103.6.1910
Caputo V, Stryker K, Ahmed S, et al. Lung herniation and torsion contributing to persistent RV dysfunction after heart-lung transplant. J Heart Lung Transplant. 2021;40:S312. doi:10.1016/j.healun.2021.01.883
Benjamen JJ, Cascade PN, Rubenfire M, Wajszczuk W, Kerin NZ. Left lower lobe atelectasis and consolidation following cardiac surgery: the effect of topical cooling on the phrenic nerve. Radiology. 1982;142:11-14. doi:10.1148/radiology.142.1.6975951
Silbert D, Herve PH, Mencsh J, et al. Proximal airways mucociliary clearance after heart-lung transplantation [abstract]. Am Rev Respir Dis. 1991;143:A458.