Pulmonary artery thrombolysis and stenting after a bilateral sequential lung transplantation.

Abstract

Bilateral sequential lung transplantation was complicated by pulmonary artery anastomotic stenosis and bilateral pulmonary thromboemboli. Pulmonary artery thrombus was eliminated by intrathrombotic but not by systemic administration of urokinase. The pulmonary emboli resulted in localized pulmonary infarctions, supporting the need for thrombolytic intervention to restore pulmonary perfusion in the absence of collateral bronchial blood flow after lung transplantation. Pulmonary artery stenosis was relieved by endovascular stenting, avoiding an early reoperative procedure. This case suggests that direct administration of thrombolytic agent may be superior to intravenous administration in the treatment of pulmonary thromboemboli. Pulmonary arterial anastomotic stenoses after lung transplantation can be relieved by endovascular procedures.

• Authors: M Bousamra 2nd, M W Mewissen, J Batter, K W Presberg, D P Schlueter, G B Haasler
• Journal: The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation (J Heart Lung Transplant) Vol. 16 Issue 6 Pg. 678-80 (Jun 1997) ISSN: 1053-2498 [Print] United States
• PMID: 9229299 (Publication Type: Case Reports, Journal Article)

Chemical References

• Urokinase-Type Plasminogen Activator

Topics

• Adult
• Anastomosis, Surgical
• Angiography
• Arteriovenous Malformations (diagnostic imaging, surgery)
• Constriction, Pathologic (diagnostic imaging, therapy)
• Female
• Humans
• Lung Transplantation (physiology)
• Postoperative Complications (diagnostic imaging, therapy)
• Pulmonary Artery (abnormalities, diagnostic imaging, drug effects)
• Pulmonary Embolism (diagnostic imaging, therapy)
• Retreatment
• Stents
• Thrombolytic Therapy
• Urokinase-Type Plasminogen Activator (administration & dosage)