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Thorac Cardiovasc Surg Rep 2014; 03(01): 045-047
DOI: 10.1055/s-0034-1376178
Case Report: Thoracic
Georg Thieme Verlag KG Stuttgart · New York

Pulmonary Pressure Necrosis due to Chronic Pleural Effusion after Heart Transplantation: A Case Report

Jae Seung Jung
1   Department of Thoracic and Cardiovascular Surgery, Korea University Medical Center, Seoul, Republic of Korea
,
Sung Ho Lee
1   Department of Thoracic and Cardiovascular Surgery, Korea University Medical Center, Seoul, Republic of Korea
,
Jeong Hyeon Lee
2   Department of Pathology, Korea University Medical Center, Seoul, Republic of Korea
,
Kyung Sun
1   Department of Thoracic and Cardiovascular Surgery, Korea University Medical Center, Seoul, Republic of Korea
› Author Affiliations
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Publication History

17 February 2014

10 March 2014

Publication Date:
29 May 2014 (online)

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Abstract

A 51-year-old woman had severe restrictive cardiomyopathy with heart failure. The first symptoms had started 12 years ago, and her symptoms gradually worsened. She was treated with diuretics, intermittent but repetitive thoracentesis, and paracentesis due to recurrent pleural effusion and ascites. Consequently, a collapse of the right lower lobe (RLL) was noted. We stopped thoracentesis and paracentesis and added continuous intravenous diuretics for 3 months before heart transplantation (HT). Finally, she underwent HT. However, her RLL remained collapsed and chest tube drainage persisted. We performed a RLL lobectomy with video-assisted thoracic surgery. No specific pathologic findings were noted except pulmonary necrotic lesions. We report a rare case of pulmonary necrosis caused by mechanical compression due to chronic pleural effusion after HT.

Keywords

transplantation - heart - pleural disease - pathology
 

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