J Cardiovasc Interv.  2022 Jul;1(3):145-150. 10.54912/jci.2022.0009.

Successful Endovascular Management of Anastomotic Stenosis of the Left Pulmonary Artery After Double Lung Transplantation

• Kim J
• Ahn CM
• Lee JG
• Paik HC
• Park MS
• Kim SY
• Lee YJ
• Lee SJ
• Hong SJ
• Kim JS
• Kim BK
• Ko YG
• Choi JY
• Choi D
• Hong MK

• KMID: 2561253
• DOI: http://doi.org/10.54912/jci.2022.0009

Abstract

Successful lung transplantation improves prognosis and quality of life in most recipients. However, some patients experience postoperative anastomotic stenosis of the pulmonary arteries. We had 3 experiences of successful angioplastic intervention for pulmonary artery stenosis (PAS) that occurred after double lung transplantation. The first case was a 56-year-old man with a history of idiopathic pulmonary fibrosis who underwent double lung transplantation. For workup of his respiratory distress, pulmonary computed tomography (CT) angiography revealed left PAS. On postoperative day 5, urgent invasive pulmonary angiography revealed total occlusion of the left pulmonary artery. Subsequently, pulmonary artery angioplasty with balloon catheter and bare metal stent implantation were performed. The second case was a 31-year-old man with a history of allogeneic peripheral blood stem cell transplantation for acute myeloid leukemia, and the third case was a 58-year-old woman with a history of ruled out idiopathic pulmonary fibrosis. After lung transplantation, each patient was evaluated by contrast-enhanced CT and Tc-99m lung perfusion scan and diagnosed with left PAS. They were successfully treated through an endovascular technique of balloon angioplasty and stent implantation, which improved symptom and clinical performance.

Keyword

Pulmonary Artery stenosis; Lung transplantation; Percutaneous transluminal angioplasty