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Radiology, Vol 190, 255-256, Copyright © 1994 by Radiological Society of North America

ARTICLES

Frequency and management of pneumothoraces in heart-lung transplant recipients

DV Paranjpe, GR Wittich, LW Hamid and CJ Bergin
Department of Radiology, Stanford University Medical Center, Calif.

PURPOSE: To determine the frequency and describe the clinical relevance of simultaneous bilateral pneumothoraces in heart-lung transplant recipients. MATERIALS AND METHODS: The chest radiographs in 72 consecutive heart-lung transplant recipients were retrospectively reviewed. The study group consisted of 15 patients with a pneumothorax that occurred after removal of surgically placed drainage tubes and subsequent complete expansion of both lungs. RESULTS: Simultaneous bilateral pneumothoraces occurred in six patients (40%); 10 episodes of unilateral pneumothorax occurred in nine patients (60%). Causes of pneumothoraces included transthoracic fine-needle biopsy (n = 5), bronchoscopic biopsy (n = 3), placement of a central venous catheter (n = 3), and thoracentesis (n = 3); no cause was found in two cases. CONCLUSION: Physicians who perform transthoracic interventions in this patient population should be aware of the likelihood of persistent pleural communications and the possibility of potentially life- threatening bilateral pneumothoraces.


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