Clamshell sternotomy in lung transplantation
30 years old female with cystic fibrosis. History of bilateral lung transplant.
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Clamshell sternotomy wires and bilateral hilar surgical clips in keeping with bilateral lung transplantation. Appropriately positioned right dialysis catheter and left arm PICC line.
Clamshell sternotomy is the standard incision for sequential bilateral lung transplantation. Recognising the "butterfly" morphology of the Kirschner wires and hila surgical clips assist to elicit this crucial piece of information.
Lung transplantation is indicated for end stage pulmonary disease most commonly from cystic fibrosis, alpha 1 antitrypsin disease, Langerhan cell histiocysosis, idiopathic pulmonary arterial hypertension, primary cystic lung disease (lymphangioleiomyomatosis) and COPD/fibrotic lung disease.