RESUMEN
PURPOSE: To determine the frequency and describe the clinical relevance of simultaneous bilateral pneumothoraces in heart-lung transplant recipients. MATERIALS AND METHODS: The chest radiographs in 72 consecutive heart-lung transplant recipients were retrospectively reviewed. The study group consisted of 15 patients with a pneumothorax that occurred after removal of surgically placed drainage tubes and subsequent complete expansion of both lungs. RESULTS: Simultaneous bilateral pneumothoraces occurred in six patients (40%); 10 episodes of unilateral pneumothorax occurred in nine patients (60%). Causes of pneumothoraces included transthoracic fine-needle biopsy (n = 5), bronchoscopic biopsy (n = 3), placement of a central venous catheter (n = 3), and thoracentesis (n = 3); no cause was found in two cases. CONCLUSION: Physicians who perform transthoracic interventions in this patient population should be aware of the likelihood of persistent pleural communications and the possibility of potentially life-threatening bilateral pneumothoraces.