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Published in: General Thoracic and Cardiovascular Surgery 6/2018

01-06-2018 | Case Report

Successful conservative management of an anastomotic airway dehiscence at the left main bronchus following bilateral cadaveric lung transplantation

Authors: Ryo Miyata, Toyofumi F. Chen-Yoshikawa, Masatsugu Hamaji, Fumiaki Gochi, Hideki Motoyama, Toshi Menju, Akihiro Aoyama, Toshihiko Sato, Makoto Sonobe, Hiroshi Date

Published in: General Thoracic and Cardiovascular Surgery | Issue 6/2018

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Abstract

There is a dearth of data on management of anastomotic airway dehiscence following lung transplantation. Herein we report a case of successful conservative management of an anastomotic airway dehiscence after cadaveric donor lung transplantation. A 41-year-old woman with primary ciliary dyskinesia underwent cadaveric bilateral lung transplantation without cardiopulmonary bypass. On the postoperative day 25, left pneumothorax developed and bronchoscopy demonstrated a localized anastomotic dehiscence at the left main bronchus. The dehiscence was managed with 2 weeks of pleural drainage and was completely covered with regenerated bronchial epithelium at 4 months after transplantation. There is no finding suggestive of significant stenosis at 4 years of follow-up. Our case suggested asymptomatic and localized anastomotic dehiscence does not always require endobronchial stent placement or re-operation. Multiple factors that may contribute to the successful conservative management were discussed in this article.
Literature
2.
go back to reference Hayes D Jr, Hatton KW, Feola DJ, Murphy BS, Mullett TW. Airway dehiscence after lung transplantation in a patient with cystic fibrosis. Respir Care. 2010;55(12):1746–50.PubMed Hayes D Jr, Hatton KW, Feola DJ, Murphy BS, Mullett TW. Airway dehiscence after lung transplantation in a patient with cystic fibrosis. Respir Care. 2010;55(12):1746–50.PubMed
3.
go back to reference Anile M, Diso D, Rendina EA, Venuta F. Airway anastomosis for lung transplantation. J Thorac Dis. 2016;8(Suppl 2):S197–203.PubMedPubMedCentral Anile M, Diso D, Rendina EA, Venuta F. Airway anastomosis for lung transplantation. J Thorac Dis. 2016;8(Suppl 2):S197–203.PubMedPubMedCentral
4.
go back to reference Garfein ES, McGregor CC, Galantowicz ME, Schulman LL. Deleterious effects of telescoped bronchial anastomosis in single and bilateral lung transplantation. Ann Transplant. 2000;5(1):5–11.PubMed Garfein ES, McGregor CC, Galantowicz ME, Schulman LL. Deleterious effects of telescoped bronchial anastomosis in single and bilateral lung transplantation. Ann Transplant. 2000;5(1):5–11.PubMed
5.
go back to reference Mughal MM, Gildea TR, Murthy S, Pettersson G, DeCamp M, Mehta AC. Short-term deployment of self-expanding metallic stents facilitates healing of bronchial dehiscence. Am J Respir Crit Care Med. 2005;172(6):768–71.CrossRefPubMed Mughal MM, Gildea TR, Murthy S, Pettersson G, DeCamp M, Mehta AC. Short-term deployment of self-expanding metallic stents facilitates healing of bronchial dehiscence. Am J Respir Crit Care Med. 2005;172(6):768–71.CrossRefPubMed
6.
go back to reference De Wauwer CV, Van Raemdonck D, Verleden GM, Dupont L, De Leyn P, Coosemans W, et al. Risk factors for airway complications within the first year after lung transplantation. Eur J Cardio Thorac. 2007;31(4):703–10.CrossRef De Wauwer CV, Van Raemdonck D, Verleden GM, Dupont L, De Leyn P, Coosemans W, et al. Risk factors for airway complications within the first year after lung transplantation. Eur J Cardio Thorac. 2007;31(4):703–10.CrossRef
7.
go back to reference Murthy SC, Blackstone EH, Gildea TR, Gonzalez-Stawinski GV, Feng J, Budev M, et al. Impact of anastomotic airway complications after lung transplantation. Ann Thorac Surg. 2007;84(2):401–9.CrossRefPubMed Murthy SC, Blackstone EH, Gildea TR, Gonzalez-Stawinski GV, Feng J, Budev M, et al. Impact of anastomotic airway complications after lung transplantation. Ann Thorac Surg. 2007;84(2):401–9.CrossRefPubMed
8.
go back to reference Yserbyt J, Dooms C, Vos R, Dupont LJ, Van Raemdonck DE, Verleden GM. Anastomotic airway complications after lung transplantation: risk factors, treatment modalities and outcome-a single-centre experience. Eur J Cardiothorac Surg. 2016;49(1):e1–8.CrossRefPubMed Yserbyt J, Dooms C, Vos R, Dupont LJ, Van Raemdonck DE, Verleden GM. Anastomotic airway complications after lung transplantation: risk factors, treatment modalities and outcome-a single-centre experience. Eur J Cardiothorac Surg. 2016;49(1):e1–8.CrossRefPubMed
10.
go back to reference Noone PG, Leigh MW, Sannuti A, Minnix SL, Carson JL, Hazucha M, et al. Primary ciliary dyskinesia: diagnostic and phenotypic features. Am J Respir Crit Care Med. 2004;169(4):459–67.CrossRefPubMed Noone PG, Leigh MW, Sannuti A, Minnix SL, Carson JL, Hazucha M, et al. Primary ciliary dyskinesia: diagnostic and phenotypic features. Am J Respir Crit Care Med. 2004;169(4):459–67.CrossRefPubMed
11.
go back to reference Frija-Masson J, Bassinet L, Honore I, Dufeu N, Housset B, Coste A, et al. Clinical characteristics, functional respiratory decline and follow-up in adult patients with primary ciliary dyskinesia. Thorax. 2017;72(2):154–60.CrossRefPubMed Frija-Masson J, Bassinet L, Honore I, Dufeu N, Housset B, Coste A, et al. Clinical characteristics, functional respiratory decline and follow-up in adult patients with primary ciliary dyskinesia. Thorax. 2017;72(2):154–60.CrossRefPubMed
12.
go back to reference Kennedy MP, Noone PG, Leigh MW, Zariwala MA, Minnix SL, Knowles MR, et al. High-resolution CT of patients with primary ciliary dyskinesia. AJR Am J Roentgenol. 2007;188(5):1232–8.CrossRefPubMed Kennedy MP, Noone PG, Leigh MW, Zariwala MA, Minnix SL, Knowles MR, et al. High-resolution CT of patients with primary ciliary dyskinesia. AJR Am J Roentgenol. 2007;188(5):1232–8.CrossRefPubMed
13.
go back to reference Ferraroli GM, Ravini M, Torre M, Valvassori L, Belloni PA. Successful treatment of bronchial dehiscence with endobronchial stent in lung transplantation. Diagn Ther Endosc. 2000;6(4):183–8.CrossRefPubMedPubMedCentral Ferraroli GM, Ravini M, Torre M, Valvassori L, Belloni PA. Successful treatment of bronchial dehiscence with endobronchial stent in lung transplantation. Diagn Ther Endosc. 2000;6(4):183–8.CrossRefPubMedPubMedCentral
14.
go back to reference McGiffin D, Wille K, Young K, Leon K. Salvaging the dehisced lung transplant bronchial anastomosis with homograft aorta. Interact Cardiovasc Thorac Surg. 2011;13(6):666–8.CrossRefPubMed McGiffin D, Wille K, Young K, Leon K. Salvaging the dehisced lung transplant bronchial anastomosis with homograft aorta. Interact Cardiovasc Thorac Surg. 2011;13(6):666–8.CrossRefPubMed
15.
go back to reference Kumar A, Alraiyes AH, Gildea TR. Amniotic membrane graft for bronchial anastomotic dehiscence in a lung transplant recipient. Ann Am Thorac Soc. 2015;12(10):1583–6.CrossRefPubMed Kumar A, Alraiyes AH, Gildea TR. Amniotic membrane graft for bronchial anastomotic dehiscence in a lung transplant recipient. Ann Am Thorac Soc. 2015;12(10):1583–6.CrossRefPubMed
Metadata
Title
Successful conservative management of an anastomotic airway dehiscence at the left main bronchus following bilateral cadaveric lung transplantation
Authors
Ryo Miyata
Toyofumi F. Chen-Yoshikawa
Masatsugu Hamaji
Fumiaki Gochi
Hideki Motoyama
Toshi Menju
Akihiro Aoyama
Toshihiko Sato
Makoto Sonobe
Hiroshi Date
Publication date
01-06-2018
Publisher
Springer Japan
Published in
General Thoracic and Cardiovascular Surgery / Issue 6/2018
Print ISSN: 1863-6705
Electronic ISSN: 1863-6713
DOI
https://doi.org/10.1007/s11748-017-0826-5

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