Correction of postpneumonectomy syndrome after bronchopleural fistula

Autor: Max S. Yudovich, Eliza W. Beal, Desmond M. D’Souza, Susan D. Moffatt-Bruce, Robert E. Merritt, Peter J. Kneuertz
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: Journal of Cardiothoracic Surgery, Vol 14, Iss 1, Pp 1-4 (2019)
Druh dokumentu: article
ISSN: 1749-8090
DOI: 10.1186/s13019-019-0897-8
Popis: Abstract Background Postpneumonectomy syndrome is a rare complication of pneumonectomy characterized by mediastinal shift toward the pneumonectomy cavity. Bronchopleural fistula (BPF) is another infrequent complication causing infection of the pneumonectomy space. The combination of both complications poses a major clinical challenge. Case presentation We present a case of successful surgical correction of postpneumonectomy syndrome in a patient with previous BPF and associated empyema. Intraoperative gram stain and cultures were used to rule out a persistent infection. Medialization of the mid and lower mediastinum was performed avoiding manipulation of the bronchial stump and its muscle buttress following previous BPF closure. Placement of intrathoracic implants resulted in resolution of symptoms. Conclusions This case highlights important clinical considerations for correction of a postpneumonectomy syndrome following BPF. A subclinical infection should be ruled out prior to placement of implants. Partial medialization and symptomatic improvement may be accomplished without disrupting the bronchial stump after healed BPF.
Databáze: Directory of Open Access Journals
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