Human En Bloc Double-Lung Transplantation: Bronchial Artery Revascularization Improves Airway Perfusion
| Autor: | Asghar Khaghani, Samad Tadjkarimi, Arve Sundset, Knut Kvernebo, Magdi H. Yacoub |
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| Rok vydání: | 1997 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty medicine.medical_treatment Bronchial Arteries Internal thoracic artery Anastomosis Revascularization Surgical anastomosis Postoperative Complications Thoracic Arteries medicine.artery Laser-Doppler Flowmetry medicine Humans Lung business.industry Anastomosis Surgical Middle Aged respiratory system Surgery Trachea Transplantation medicine.anatomical_structure Case-Control Studies Anesthesia Female Cardiology and Cardiovascular Medicine business Bronchial artery Perfusion Lung Transplantation Artery |
| Zdroj: | The Annals of Thoracic Surgery. 63:790-795 |
| ISSN: | 0003-4975 |
| DOI: | 10.1016/s0003-4975(96)01273-8 |
| Popis: | Ischemic airway complications are common after en bloc double-lung transplantation with tracheal anastomosis. The aim of this study was to evaluate the effects of a direct revascularization of the donor bronchial artery with the recipient internal thoracic artery on airway perfusion.Seven patients undergoing double-lung transplantation with tracheal anastomosis were investigated intraoperatively and postoperatively (12 to 36 hours) with endoscopic laser Doppler flowmetry. Sixteen patients undergoing coronary artery bypass grafting served as a control group.Two patients who had double-lung transplantation with tracheal anastomosis died of sepsis and multiorgan failure 1 week after transplantation. In the remaining 5 patients healing of the anastomosis was excellent during the observation period of 3 to 52 months. In 5 patients clamping of the attached internal thoracic artery induced a reduction of the laser Doppler flowmetry signal from 10% to 60%. In the 2 patients with the highest graft perfusion level, no clamping effect could be detected. Compared with the control group, perfusion was significantly higher in the transplanted airways intraoperatively, at 71 versus 55 arbitrary perfusion units (p0.01). Postoperative transplant airway perfusion values were not significantly different from the intraoperative value. The coefficient of variation of repeated measurements was higher in the transplanted airways, with a coefficient of variation of 0.22 versus 0.17 in the control group (p0.01), indicating heterogeneous transplant airway perfusion.This study has documented that revascularization with the internal thoracic artery supplies the transplanted airway with additional oxygenated blood. |
| Databáze: | OpenAIRE |
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