Right Upper Lobectomy Twenty Years After Left Pneumonectomy

Quantitative perfusion lung scanning coupled with spirometry and balloon occlusion of the pulmonary artery supplying the lung to be resected have been used to predict the potential operability of patients being considered for pneumonectomy. These techniques were adapted for the lobar level prior to performing a right upper lobectomy in a 59-year-old man who had undergone a left pneumonectomy 20 years previously. This case demonstrates how physiologic reserve can be predicted in patients who require sequential pulmonary resection. (Chest 1990; 97:248-50)