Clamshell sternotomy for bilateral total lung transplant

Case contributed by Dr Jayanth Keshavamurthy

Presentation

Acute shortness of breath and fever

Patient Data

Age: 50 years
Gender: Male

Post-op radiograph 6/12 later

X-ray

Moderate patchy pulmonary alveolar opacities bilaterally which may represent multifocal pneumonia. Interval increase in size of the cardiac silhouette. Prominent central pulmonary arteries.

 

6 months prior to transplant

X-ray

Case Discussion

Patient has undergone clamshell sternotomy for bilateral total lung transplant six months earlier, 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 chest for specifically ILD protocol in inspiration and expiration, please specify like this in order to evaluate for any graft versus host disease/rejection/immunocompromised infections

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