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European Journal of Cardio-Thoracic Surgery, Vol 6, 490-495, Copyright © 1992 by European Association for Cardio-thoracic Surgery

ARTICLES

Lung transplantation with bronchial revascularisation. Surgical anatomy, operative technique and early results

L Couraud, E Baudet, SA Nashef, C Martigne, X Roques, JF Velly, N Laborde, J Dubrez and F Clerc
Department of Thoracic Surgery, Hopital Xavier Arnozan, Bordeaux- Pessac, France.

Ischaemic anastomotic complications are an important cause of mortality and morbidity after lung transplantation. Anatomical studies have demonstrated that the pattern of bronchial arterial supply is relatively constant and therefore amenable to attempts at revascularisation. From May 1990, 10 patients who had a double lung transplantation (tracheal anastomosis) and 1 patient who had a right lung transplantation underwent concomitant bronchial revascularisation. There were two early and one late deaths. There were no anastomotic complications. Regular endoscopic examination showed satisfactory healing in all patients. Early angiography showed patent grafts in 7 of 9 patients. At a mean follow-up of 11 months (range 6-17 months) 8 patients are well and leading a normal life. This report describes the anatomical basis, technical aspects and early results of a promising operative procedure in the field of lung transplantation.

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