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J Thorac Cardiovasc Surg 2007;133:272-273
© 2007 The American Association for Thoracic Surgery

Brief Communication

Technique of right single-lung transplantation for idiopathic pulmonary fibrosis using cross-field ventilation

^a Division of Cardiothoracic Surgery, Emory University, Atlanta, Ga
^b Division of Pulmonary Medicine, Emory University, Atlanta, Ga
^c Department of Anesthesiology, Emory University, Atlanta, Ga.

Received for publication July 24, 2006; accepted for publication September 5, 2006.

^_* Address for reprints: Seth D. Force, MD, The Emory Clinic, Rm 2213, 1365 Clifton Rd, NE Atlanta, GA 30324. (Email: seth_force@emoryhealthcare.org).

The first 20% of the full text of this article appears below.

Isolated lung ventilation for single or bilateral sequential lung transplantation can be achieved with either a double-lumen endotracheal tube or a single-lumen endotracheal tube with a bronchial blocker. However, situations might arise that call for alternative methods of ventilation until the airway can be stabilized. We present a patient in whom we were unable to achieve isolated lung ventilation using standard techniques but were successful with cross-field ventilation of the nontransplanted lung during a right single-lung transplantation.

Clinical Summary

A 54-year-old man presented for lung transplantation evaluation with end-stage lung disease caused by pulmonary fibrosis. A chest computed tomographic scan performed as part of the transplantation evaluation showed fibrotic lung disease bilaterally and a significant rightward angulation of the trachea (Figure 1). Bronchoscopy confirmed the severe deviation of the trachea and revealed the right upper lobe bronchus and bronchus intermedius to be coming directly off of the trachea. A quantitative ventilation-perfusion scan . . . [Full Text of this Article]