Bimodal assessment to facilitate accurate mediastinal repositioning following pneumonectomy.

To cite: Kimpton J, Teh E, Cogswell L, et al. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2015211190 DESCRIPTION We present a case with a successful use of mixed silicone and saline implant expanders to achieve mediastinal repositioning facilitated by periprocedural bimodal assessment. A 63-year-old man with a large central tumour underwent right pneumonectomy. He developed stridor with dyspnoea 3 months later. Clinical and radiological findings were consistent with postpneumonectomy syndrome (figure 1A, B). 2 Mediastinal repositioning was undertaken through the placement of silicone and saline-filled prostheses at rethoracotomy. Intraoperative bronchoscopy was performed to facilitate centralisation of mediastinum. Subcutaneous ports and early CT scanning allowed assessment of positioning. Postoperative imaging (figure 2A, B) confirmed centralisation of mediastinum. This resulted in significant and durable symptomatic relief.