Sequential Double-Lung Transplantation In Kartagener Syndrome: A Case Report.

Catarina Nunes Figueiredo, João Santos Silva, João Maciel, Luísa Semedo, Paulo Calvinho
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Abstract

Kartagener syndrome (KS) is a rare congenital disorder, characterized by sinusitis, bronchiectasis and situs inversus. Lung transplantation is an effective treatment for end-stage lung failure, but dextrocardia and differences between hilar structures and pulmonary lobes require adjustments to conventional surgical technique. We present a case of a double-lung transplant without extracorporeal oxygenation in a 48-year-old male patient with KS. Through a Clamshell incision, right-left rotation was identified. To provide an end-to-end arterial and bronchial anastomosis, longer donor PA's and right main bronchus were preserved. Wedge resection of right inferior lobe was unnecessary and there was no left residual cardiac chamber. Patient was discharged 32 days after surgery without complications. Despite being anatomically challenging, lung transplant was done successfully without the need for plastic maneuvers or extracorporeal circulation. This reinforces the idea that it should be an option in end-stage lung disease.

序贯双肺移植治疗Kartagener综合征1例。
Kartagener综合征(KS)是一种罕见的先天性疾病,以鼻窦炎、支气管扩张和倒位为特征。肺移植是治疗终末期肺衰竭的有效方法,但右心和肺门结构与肺叶的差异需要对传统的手术技术进行调整。我们提出一个病例双肺移植没有体外氧合在一个48岁的男性患者与KS。通过蛤壳切口,确定了左右旋转。为了提供端到端的动脉和支气管吻合,保留较长的供体肺动脉和右主支气管。右下叶不需要楔形切除,左心室未残留。术后32天出院,无并发症。尽管在解剖学上具有挑战性,但肺移植在不需要整形手术或体外循环的情况下成功完成。这加强了它应该是终末期肺病的一种选择的观点。
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