Clam shell sternotomy for bilateral total lung transplant

Case contributed by Dr Jayanth Keshavamurthy


50 year old male presents to Emergency with shortness of breath and fever.

Patient Data

Age: 50
Gender: Male

Moderate patchy pulmonary alveolar opacities are seen bilaterally which may represent multifocal pneumonia 

There is interval increase in the size of the cardio-pericardiac silhouette. There is prominent central pulmonary arteries.

This x ray performed 6 months before before the lung transplant. Classic case of upper lobe bronchiectasis from cystic fibrosis.

Case Discussion

Patient has undergone clam shell sternotomy for bilateral total lung transplant six months eariler, with sternal suture wires in the craniocaudal dimension.

Further recommendations include

  1. Echocardiogram of the heart to evaluate for ejection fraction.
  2. High resolution CT scan of the chest for specifically ILD protocol in inspiration and expiration, please specify like this in order to evaluate any graft versus host disease/rejection/immunocompromised infections.
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Case information

rID: 34965
Published: 17th Mar 2015
Last edited: 18th Dec 2016
System: Chest
Inclusion in quiz mode: Included

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