Clamshell sternotomy in lung transplantation

Case contributed by Charlie Chia-Tsong Hsu
Diagnosis not applicable

Presentation

30 years old female with cystic fibrosis. History of bilateral lung transplant.

Patient Data

Age: 30 years
Gender: Female

Clamshell sternotomy wires and bilateral hilar surgical clips in keeping with bilateral lung transplantation. Appropriately positioned right dialysis catheter and left arm PICC line. 

Case Discussion

Clamshell sternotomy is the standard incision for sequential bilateral lung transplantation. Recognizing 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 histiocytosis, idiopathic pulmonary arterial hypertension, primary cystic lung disease (lymphangioleiomyomatosis) and COPD/fibrotic lung disease.

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