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Ann Thorac Surg 1995;59:1223-1226
© 1995 The Society of Thoracic Surgeons

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Case Report

Right Lower Lobe Herniation After Domino Heart-Lung Transplantation

Department of Cardiac Surgery and North West Lung Centre, Wythenshawe Hospital, Manchester, England

Accepted for publication September 12, 1994.

We report 2 cases of trapping and incarceration of the right lower lobe in the left hemithorax after heart-lung transplantation with bicaval anastamoses (domino donors). This occurred despite confirmation of the normal anatomy at the time of implantation, before lung inflation. In 1 case this complication resulted in a right lower lobectomy 7 days after transplantation due to infarction and infection of the right lower lobe. These cases illustrate the importance of reexamining the anatomy after lung inflation, before chest closure.

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