The postpneumonectomy syndrome is a rare complication occurring after right pneumonectomy and is seen mainly after pneumonectomy in childhood. The presenting symptoms are dyspnea, stridor, and recurrent pulmonary infections. The syndrome is caused by the shifting and rotation of the heart and mediastinum into the right hemithorax, and anterior herniation of the left lung. This causes tortuosity and stretching of the trachea and compression of the left main bronchus and left lower lobe bronchus, eventually resulting in secondary tracheobronchomalacia. This report reviews two cases of postpneumonectomy syndrome following pneumonectomy in adulthood. After implantation of an expandable prosthesis, an anatomic correction of the shifted mediastinum was achieved, which in both cases resulted in instantaneous and sustained relief.
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http://dx.doi.org/10.1378/chest.101.4.1167 | DOI Listing |
JACC Case Rep
December 2024
Division of Acute Care and Trauma Surgery, Department of Surgery, Kern Medical Center, Bakersfield, California, USA.
Postpneumonectomy syndrome (PPS) is a rare postoperative phenomenon characterized by dynamic airway obstruction and circulatory collapse resulting from excessive mediastinal shifting and rotation of critical structures. This paper presents a novel case of PPS manifesting approximately 3 decades after pneumonectomy in an acutely symptomatic 28-year-old man with clinical findings concerning for impending airway collapse. Cardiac computed tomography and pulmonary function testing were used as alternative, noninvasive means of monitoring for disease advancement.
View Article and Find Full Text PDFRespir Med Case Rep
September 2024
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
Background: It is rare for an adult patient to be living decades after a pneumonectomy procedure. This case features complications that can arise. We utilize cardiopulmonary exercise stress testing (CPET) to highlight long-term physiologic changes that can present in a post-pneumonectomy patient.
View Article and Find Full Text PDFIndian J Anaesth
August 2024
Department of Cardiothoracic Surgery, Government Medical College and Hospital, Chandigarh, India.
Surg Case Rep
July 2024
Department of General Thoracic Surgery, Kagoshima University Graduate School of Dental and Medical Science, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.
Background: Post-pneumonectomy syndrome (PPS) is a rare but serious condition that can occur after pneumonectomy. It is characterized by a mediastinal shift towards the vacated hemithorax, which can potentially lead to respiratory failure. The management of PPS poses a clinical challenge, especially in the context of the limited availability of certain therapeutic devices due to regulatory restrictions in Japan.
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