BRONCHIAL DEHISCENCE AFTER LUNG TRANSPLANTATION - CORRELATION OF CT FINDINGS WITH CLINICAL OUTCOME

PURPOSE: To determine whether computed tomography (CT) can help predic t which patients will require surgical or bronchoscopic intervention d uring healing of bronchial anastomotic dehiscence after lung transplan tation. MATERIALS AND METHODS: The authors followed up 25 bronchoscopi cally proved dehiscent anastomoses through healing in 19 patients who underwent lung transplantation. CT findings were correlated with bronc hoscopic results and clinical outcome. RESULTS: A bronchial defect and extraluminal air were initially present at CT in all 25 dehiscent ana stomoses. Of 12 bronchial defects less than or equal to 4 mm, only one required intervention during healing (P < .05). Of 12 bronchial defec ts greater than 4 mm, six required intervention during healing. Eight of nine dehiscences with a tiny or small amount of extraluminal air he aled with conservative treatment. Of it dehiscences associated with a moderate to large amount of extraluminal air, nine were treated conser vatively and six required therapeutic intervention. Three healing anas tomoses required bronchial stent placement. One patient died in the pe rioperative period. CONCLUSION: In patients with small dehiscences (< 4 mm) and patients with a tiny or small amount of extraluminal air, th e anastomosis tends to heal without sequela. When patients have larger amounts of extraluminal air or larger (> 4 mm) dehiscences at present ation, CT cannot help predict which patients will require intervention .