Pulmonary Vein Stenosis After Lung Transplantation Successfully Treated With Stent Implantation

A 31-year-old white woman with end stage idiopathic pulmonary fibrosis underwent left lung transplantation in our institution in January 2010. Oxygenation could be preserved by the native right lung, so surgery was performed without cardiopulmonary bypass. The procedure was uneventful and a bronchoscopic assessment of the graft showed only mild edema of the mucosa. In the early postoperative course gas exchange was difficult to maintain, requiring high FiO2 and positive end-expiratory pressure. Chest x-ray demonstrated alveolar infiltrates in the graft (Figure 1A). Due to the suspicion of reperfusion edema, an infusion of furosemide was initiated, although only a partial resolution of the congestion was achieved. The patient was successfully extubated 5 days after intervention, however reintubation was needed within 24 hours due to desaturation and inadequate response to noninvasive ventilation. At this time point a bronchoscopic evaluation was carried …