Vascular complications of lung transplantation

Clark, Stephen; Levine, Adrian; Hasan, Asif; Hilton, Colin J.; Forty, J.; Dark, John H.

doi:10.1016/0003-4975(96)00003-3

Cited by 100 publications

(96 citation statements)

References 5 publications

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“…They can benefit from multiplanar reformations for their diagnosis and pretherapeutic management. Similarly, MPRs and 3D can avoid a more invasive evaluation of posttranplantation vascular stenoses, usually investigated by pulmonary angiography, considered as the gold standard imaging modality by Clark et al [34]. Whatever the transplanted lung, the majority of arterial strictures are short and horizontally oriented.…”

Section: Pulmonary Vesselsmentioning

confidence: 98%

Multiplanar and three-dimensional reconstruction techniques in CT: impact on chest diseases

et al. 1998

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The purpose of this review is to capture the current state-of-the art of the technical aspects of multiplanar and three-dimensional (3D) images and their thoracic applications. Planimetric and volumetric analysis resulting from volumetric data acquisitions obviates the limitations of segmented transverse images. Among the 3D reconstruction techniques currently available, the most recently introduced technique, i. e., volume rendering, has to be evaluated in comparison with 3D shaded surface display and maximum or minimum intensity projection. Slabs are useful in detecting and localizing micronodular or microtubular patterns and in analyzing mild forms of uneven attenuation of the lungs. Three-dimensional angiography is helpful in the pretherapeutic evaluation and posttreatment follow-up of pulmonary arteriovenous malformations, in the comprehension of the postoperative reorientation of the pulmonary vessels, in the surgical planning of pulmonary tumors, and in the diagnosis of marginated thrombi. The systemic supply to the lung and superior vena cava syndromes are also relevant to these techniques. In acquired or congenital tracheobronchial diseases including stenosis, extraluminal air and complex airway anatomy, multiplanar and 3D reformations have a complementary role to both transaxial images and endoscopy. New developments are also expected in various topics such as 3D conformal radiation therapy, planning of intraluminal bronchoscopic therapy, virtual endoscopy, and functional imaging of the bronchial tree. Miscellaneous clinical applications are promising in the analysis of diaphragmatic morphology and pathophysiology, in the volumetric quantification of the lung parenchyma, and in the vascular components of the thoracic outlet syndromes.

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Section: Pulmonary Vesselsmentioning

confidence: 98%

Multiplanar and three-dimensional reconstruction techniques in CT: impact on chest diseases

et al. 1998

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“…[174][175][176][177][178][179][180][181] Emellett létrejöhet tüdővéna-transzpozí-ció sebészi korrekciójának következtében 174,[182][183][184][185][186][187][188][189] vagy tüdő-transzplantáció után is. [190][191][192][193] Felnőtt betegekben a pulmonalis vénák szűkülete kialakulhat a pitvarfibrilláció miatt végzett rá-diófrekvenciás ablatiót követően is. [194][195][196][197][198][199][200][201][202][203][204][205][206][207][208][209] Ritkább okai közé tartozik a tumorok, sarcoidosis vagy mediastinitis miatti külső kompresszió.…”

Section: Pulmonalis Vénákunclassified

Indications for Cardiac Catheterization and Intervention in Pediatric Cardiac Disease

Feltes¹,

Bacha

Beekman³

et al. 2011

Circulation

720

571

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“…Clark et al report on one patient who underwent angioplasty and stenting of pulmonary vein stenosis following lung transplantation who remained well for 21 months post procedure [3].…”

Section: Discussionmentioning

confidence: 99%

“…Non-surgical methods include pulmonary angioplasty ± stenting, especially for high-risk patients [3]. Successful pulmonary angioplasty and stenting of pulmonary artery stenosis has been reported and has led to improvement in the patients' respiratory perfusion.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous dilatation of right inferior pulmonary vein stenosis following single-lung transplant

Mydin¹,

Calvert²,

Jenkins³

et al. 2012

Interactive CardioVascular and Thoracic Surgery

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We present a 62-year old male who underwent right single-lung transplantation. An autologous pericardial rim was constructed at implantation, as there was insufficient donor atrial cuff. The patient was discharged home but deteriorated over 12 months resulting in oxygen dependency. Computed tomography scan showed stenosis of the right inferior pulmonary vein. The patient underwent pulmonary vein angioplasty under general anaesthesia in September 2007, which was successful and resulted in significant improvement in clinical status. However, his symptoms recurred 2 months later and a second attempt at angioplasty failed. He died 6 weeks later. Keywords: Vein restenosis • Anastomosis • Lung transplantation CASE REPORTWe present the case of a 62-year old man who underwent right single-lung transplantation for usual interstitial pneumonitis (UIP) on 31 August 2006. The UIP was associated with 'SS' phenotype of alpha-1 antitrypsin deficiency. The patient had both physiological and radiographical findings, consistent with a mixed restrictive and obstructive pattern. His only significant medical history was osteoporosis, secondary to steroid usage.Right single-lung transplantation was performed on cardiopulmonary bypass as the patient had moderate pulmonary hypertension. The donor lung was found to have a deficient left atrial cuff with six small vein orifices and minimal atrial cuff tissue infero-posteriorly. This was repaired using an autologous pericardial patch with 4/0 prolene to create suitable rim for anastomosis to the recipient left atrium. This neo-cuff subsequently formed three quarters of the circumference of the anastomosis with the donor LA forming the other quarter ( Figs. 1 and 2). At the end of the procedure, good drainage was confirmed by transoesophageal echocardiogram (TOE), and the patient came off bypass easily with good gas exchange.Early postoperative recovery was uncomplicated. He was started on a calcineurine inhibitor, mycophenolate mofetil and prophylaxis for Pneumocystic Carinii Pneumonia (PCP)/cytomegalovirus (CMV). Over the following 12 months, the patient's respiratory function deteriorated and he became bed-bound and oxygen dependent. He was treated for CMV pneumonitis and aspergillosis. Computed tomography (CT) scanning demonstrated a stenosis at the level of the right inferior pulmonary vein (RIPV) where the vessel measured 2 mm in diameter. The CT scan also demonstrated areas of pulmonary venous infarction upstream of the stenosis. In view of his clinical state, he was considered to be too high risk for surgical intervention.It was, therefore, decided to attempt percutaneous dilatation of the stenosed RIPV. This was performed under general anaesthesia (GA) with TOE and fluoroscopic guidance. Access was gained to the right atrium via the right femoral vein and transseptal puncture was performed with a Brockenbrough Needle (Medtronic, MA) and a 9F-Preface sheath (Biosense Webster, CA). Access to the RIPV from the trans-septal puncture was difficult and, ultimately, the RIPV was ...

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Vascular complications of lung transplantation

Cited by 100 publications

References 5 publications

Multiplanar and three-dimensional reconstruction techniques in CT: impact on chest diseases

Multiplanar and three-dimensional reconstruction techniques in CT: impact on chest diseases

Indications for Cardiac Catheterization and Intervention in Pediatric Cardiac Disease

Percutaneous dilatation of right inferior pulmonary vein stenosis following single-lung transplant

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