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Contralateral Tension Pneumothorax Following Unilateral Chest Tube Drainage of Bilateral Pneumothoraces in a Heart-Lung Transplant Patient*

Y.C. (Gary) Lee, MBChB; Gregory B. McGrath, MBBS; Weng S. Chin, MBBS; Richard W. Light, MD, FCCP
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*From the Department of Respiratory Medicine (Drs. Lee, McGrath, and Chin), Sir Charles Gairdner Hospital, Perth, Australia; and the Division of Pulmonary Medicine (Drs. Lee and Light), St. Thomas Hospital and Vanderbilt University, Nashville, TN.

Correspondence to: Richard W. Light, MD, FCCP, Department of Pulmonary Medicine, St. Thomas Hospital, 4220 Harding Road, Nashville TN 37202; e-mail: rlight98@yahoo.com



Chest. 1999;116(4):1131-1133. doi:10.1378/chest.116.4.1131
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Bilateral pneumothoraces can result from unilateral air leak after heart-lung transplantation. The recommended initial management of such patients is insertion of a unilateral chest tube. We report a patient who developed bilateral pneumothoraces after undergoing transbronchial biopsies 2 years after a heart-lung transplant. The unilateral chest tube failed to drain the contralateral pneumothorax and a tension pneumothorax developed. The advocated approach should be used with caution.

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