症例報告
生体肺移植ドナー手術後心膜炎の1例
2020 年 55 巻 2 号 p. 91-95
詳細
2020 年 55 巻 2 号 p. 91-95
Pericarditis is an uncommon complication following living-donor lung lobectomy surgeries. Here we report a case who developed pericarditis that showed constrictive patterns in echocardiography two months after a lung donation surgery. The patient was a male in his 30s who underwent a left lower lung lobectomy as a donation surgery in the setting of a living-related lung transplantation. Pericardium was incised then half-closed upon transecting the pulmonary vein. Five weeks after the surgery, the patient was readmitted due to having a moderate amount of pericardial effusion with an elevation of the serum CRP level. Pericarditis was diagnosed, and the patient was treated with colchicine. Although the CRP level normalized within several weeks, plasma BNP level rose up to 170 pg/mL. Echocardiography revealed an early diastolic notch of the ventricular septum and a reversal flow of the hepatic vein on inspiration, suggesting patterns of constrictive pericarditis. The patient was closely observed, after which the echocardiography findings and the BNP level normalized. Such a clinical course could be regarded as a postpericardiotomy syndrome and should be considered in the management of living-donor lung transplantations.
