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Open Respir Arch
Open Respir Arch
Open Respiratory Archives
2659-6636
Elsevier

S2659-6636(24)00074-2
10.1016/j.opresp.2024.100352
100352
Clinical Image
Aortic Dissection in a Patient With Lung Transplantation
Disección aórtica en un paciente trasplantado pulmonarPadín Pico Guillermo padin.pico.guillermo@gmail.com
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Erro Iribarren Marta
Aguilar Pérez Myriam
Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
⁎ Corresponding author. padin.pico.guillermo@gmail.com
26 7 2024
Oct-Dec 2024
26 7 2024
6 4 100352© 2024 Sociedad Española de Neumología y Cirugía Torácica (SEPAR). Published by Elsevier España, S.L.U.
2024
Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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pmcSurgical complications after lung transplantation are relatively common, mainly in the first month.1 We would like to present a case of an aortic dissection as a surgical complication.

This is a 64-year-old male who underwent double lung transplantation. The postoperative period proceeded without significant complications and the standard postoperative tests did not show relevant abnormalities.

After discharge, the patient started with progressive dyspnea and a chylothorax was diagnosed. A CT scan was performed to determine the cause, and incidentally, it revealed that the suture of the median sternotomy had come loose, which was likely the origin of the chylothorax. During readmission the pleural drainage remained high, so a new chest CT scan was done and we could see that one of the wires from the sternotomy was directed towards the mediastinum (Fig. 1, Fig. 2), next to the ascending aorta and the trunk of the pulmonary artery. A type A aortic dissection (AD) from the aortic root to the aortic arch was diagnosed.Fig. 1 Thoracic aorta CT angiography (sagittal MIP reconstruction) showing a type A dissection flap extending from the aortic root to the aortic arch, adjacent to the displaced sternal suture fragment.

Fig. 2 Axial CT scan of the thoracic aorta showing the suture thread directed towards the ascending aorta.

This is the first case that describes an AD as a complication after sternal suture wire migration in a lung transplantation patient. Although this complication, the patient evolution after 1 year is satisfactory.

Informed consent

We have obtained the patient's consent to publish this article after providing the necessary information.

This study has not passed the ethics committee because it is not necessary to present this clinical case.

Funding

No funding was needed to create this paper.

Authors’ contributions

All three authors have contributed to the creation of this paper.

Conflicts of interest

The authors declare no conflicts of interest.
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Reference

1 Paul N. Patsios D. Walsham A. Chung T.-B. Keshavjee S. Imaging of lung trasplantation: review Am J Roentgenol. 192 3 Suppl 2009 10.2214/AJR.07.7061
