Division of Cardiology, Department of Cardiac Science, University of Calgary, Calgary, AB T2N 2T9, Canada.
Chest. 2010 Jan;137(1):205-6. doi: 10.1378/chest.09-0140.
Postpneumonectomy syndrome is a recognized complication following pneumonectomy, resulting from mediastinal displacement into the vacated pleural space. Mediastinal displacement causes bronchial compression and dyspnea. This report describes a 47-year-old woman who presented with shortness of breath 6 months after a left pneumonectomy. She was initially hypoxic and was found to have a patent foramen ovale. Following closure of the patent foramen ovale, she was no longer hypoxic, but she continued to have dyspnea with exertion and left lateral decubitus positioning. There was no evidence of bronchial compression, but MRI and transesophageal echocardiography suggested pulmonary vein compression due to mediastinal displacement. Transthoracic echocardiography confirmed functional pulmonary vein compression that was worse in the standing and in the left lateral positions. Her symptoms improved with mediastinal repositioning using a transesophageal echocardiography-guided approach. Positional pulmonary vein compression may be an underdiagnosed complication of pneumonectomy.
术后肺切除综合征是肺切除术后一种公认的并发症，是由于纵隔移位到空的胸腔空间引起的。纵隔移位导致支气管受压和呼吸困难。本报告描述了一位 47 岁女性，在左肺切除术后 6 个月出现呼吸困难。她最初有缺氧，发现卵圆孔未闭。卵圆孔未闭关闭后，她不再缺氧，但仍在用力和左侧卧位时呼吸困难。没有支气管受压的证据，但 MRI 和经食管超声心动图提示纵隔移位导致肺静脉受压。经胸超声心动图证实了功能性肺静脉受压，站立和左侧卧位时更为严重。使用经食管超声心动图引导的方法进行纵隔复位后，她的症状得到了改善。位置性肺静脉受压可能是肺切除术后被低估的并发症。
