Lodhi Samra Haroon, Nandavaram Sravanthi, Malyala Raj, Anstead Michael, Keshavamurthy Suresh
Pulmonary, Critical Care and Sleep Medicine, University of Kentucky, Lexington, USA.
Cardiothoracic Surgery, University of Kentucky, Lexington, USA.
Cureus. 2022 Mar 11;14(3):e23070. doi: 10.7759/cureus.23070. eCollection 2022 Mar.
Lung transplantation is increasingly being performed for end-stage lung disease in patients with bronchiectasis and pulmonary hypertension. Outcomes of bilateral lung transplantation (BLT) are better in patients with pulmonary hypertension, whereas single lung transplant remains a controversy in bronchiectasis with fear of infections from the residual diseased lung. However, in patients with adhesions and extreme structural changes due to severe disease, BLT may be considered technically challenging. We describe a case of successful management of a patient with bronchiectasis-induced lung disease causing extreme mediastinal shift with a BLT. The patient was successfully bridged to transplant with central veno-arterial extracorporeal membrane oxygenation (VA-ECMO) for acute decompensated pulmonary hypertension while awaiting transplantation.
对于患有支气管扩张症和肺动脉高压的终末期肺病患者，肺移植手术的开展越来越多。在肺动脉高压患者中，双侧肺移植（BLT）的效果更好，而单肺移植在支气管扩张症患者中仍存在争议，因其担心来自残留病变肺的感染。然而，对于因严重疾病导致粘连和极端结构改变的患者，BLT在技术上可能具有挑战性。我们描述了一例成功治疗因支气管扩张症引起的肺病导致极端纵隔移位的患者并进行BLT的病例。该患者在等待移植期间，通过中心静脉 - 动脉体外膜肺氧合（VA - ECMO）成功度过急性失代偿性肺动脉高压期，顺利过渡到移植手术。
