Coronary artery bypass in a patient with Swyer-James syndrome due to pulmonary tuberculosis

Abstract

Swyer-James syndrome (SJS) is a result of post infectious obliterative bronchiolitis. In SJS, the involved lung or portion of the lung does not grow normally and is smaller than the opposite lung. A 66-year-old man with a history of treated pulmonary tuberculosis 43 years ago was hospitalized for coronary artery bypass graft (CABG) surgery. He had decreased breath sounds in the left hemithorax on auscultation. Chest X-ray (Fig. 1) and computed tomography (Fig. 2) revealed the characteristic radiographic appearance of SJS including hyperlucency, reduced left lung volume, diminished vascularity, bronchiectasis and deviation of the heart into the left hemithorax. No tumoral growth can be seen in these images. Forced expiratory volume in the first second (FEV1) was 61%, FVC (forced vital capacity) was 69%, FEV1/FVC ratio was 70% in the respiratory function tests. PH was 7.4, PCO2 was 35 mmHg, PO2 was 81 mmHg in blood gas analysis.