Pneumonectomy without Thoracoplasty in Pulmonary Tuberculosis

A ten year follow-up of lung and heart function

¹ Berg en Bosch Hospital

1. The follow-up of lung and heart function of 30 patients treated by pneumonectomy without thoracoplasty has been continued up to nine years.

2. After an increase over the first years, both V.C and T.C. remain constant. The R.V. shows no increase. Although the V.C. is raised, its usable part is somewhat lower than normal resulting in a M.B.C. about normal. The influence of the age at pneumonectomy on the lung capacities has been checked. Oxygen saturation and pCO₂ both at rest and during exercise are normal in most cases.

3. At rest the diffusion capacity of the remaining lung is at a level above the normal value for this lung. During exercise the normal maximum level for the diffusion capacity of the remaining lung is reached by the right lung and surpassed by about 20 per cent by the left lung.

4. After pneumonectomy the cardiac output equals the normal value for the cardiac output in the presence of both lungs.

5. No indication of a progressive emphysematous degeneration of the remaining lung has been found. Reasons are given for considering thoracoplasty a most harmful intervention.

6. After pneumonectomy moderate exercise places a heavy burden on the right heart; this, together with a more restricted ventilation may lead to dyspnea and cor pulmonale in older patients.