Abstract
A 51-year-old woman had severe restrictive cardiomyopathy with heart failure. The
first symptoms had started 12 years ago, and her symptoms gradually worsened. She
was treated with diuretics, intermittent but repetitive thoracentesis, and paracentesis
due to recurrent pleural effusion and ascites. Consequently, a collapse of the right
lower lobe (RLL) was noted. We stopped thoracentesis and paracentesis and added continuous
intravenous diuretics for 3 months before heart transplantation (HT). Finally, she
underwent HT. However, her RLL remained collapsed and chest tube drainage persisted.
We performed a RLL lobectomy with video-assisted thoracic surgery. No specific pathologic
findings were noted except pulmonary necrotic lesions. We report a rare case of pulmonary
necrosis caused by mechanical compression due to chronic pleural effusion after HT.
Keywords
transplantation - heart - pleural disease - pathology
