Pulmonary Pressure Necrosis due to Chronic Pleural Effusion after Heart Transplantation: A Case Report

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.