Lung Transplantation and Cardiac Repair for Adult Congenital Heart Disease

• Published in: Japanese Journal of Transplantation Vol. 58; no. Supplement; p. s144_1
• Main Authors: Kimura, Toru, Ose, Naoko, Shintani, Yasushi, Fukui, Eriko, Soichiro, Funaki, Kanou, Takashi
• Format: Journal Article
• Language: English
• Published: The Japan Society for Transplantation 2023; 一般社団法人 日本移植学会
• ISSN: 0578-7947; 2188-0034
• DOI: 10.11386/jst.58.Supplement_s144_1

Aorta-pulmonary window (APW) is a rare congenital cardiac anomaly characterized by communication between the pulmonary artery and ascending aorta, which sometimes leads to Eisenmenger syndrome (ES). A 29-year-old female with an APW and Eisenmenger syndrome underwent brain-dead bilateral lung transplantation and APW repair procedures. The communication between the aorta and pulmonary artery was transected, then the pulmonary artery and aortic side were directly closed with felt strips. Thereafter, bilateral single lung transplantation (LTX) was performed in the usual manner. The patient was doing well without heart failure or graft rejection. Nine months following the LTX, the patient complained of chest pain, and chest CT scan findings revealed an ascending aortic pseudoaneurysm at the anastomotic site, thus emergency operation was performed. Under hypothermia to stop circulation, the aneurysm was resected, and ascending aortic artery replacement was performed. The postoperative course was uneventful. Presented here are details of the surgical techniques used as well as a discussion regarding this experience with an LTX procedure for APW.