Emmanuel Martinod, MD, PhD, Dana M

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Presentation transcript:

Human Transplantation of a Biologic Airway Substitute in Conservative Lung Cancer Surgery Emmanuel Martinod, MD, PhD, Dana M. Radu, MD, Kader Chouahnia, MD, Agathe Seguin, MD, PhD, Anne Fialaire-Legendre, MD, Pierre-Yves Brillet, MD, PhD, Marie-Dominique Destable, MD, Georges Sebbane, MD, Sadek Beloucif, MD, PhD, Dominique Valeyre, MD, PhD, Christophe Baillard, MD, PhD, Alain Carpentier, MD, PhD The Annals of Thoracic Surgery Volume 91, Issue 3, Pages 837-842 (March 2011) DOI: 10.1016/j.athoracsur.2010.11.013 Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Preoperative evaluation. (A) Positron emission tomography (PET) at time of diagnosis. (B) PET after 3 cycles of neoadjuvant chemotherapy. (C) PET at time of diagnosis showing increased 18F-fluoro-2-deoxyglucose ([18F]FDG) uptake at the site of lung tumor. (D) Computed tomography (CT) scan at time of diagnosis showing a large tumor extending to the middle lobe, the upper lobe, and the left atrium. (E) PET scan after 3 cycles of neoadjuvant chemotherapy showing increased [18F]FDG uptake at the site of lung tumor. (F) CT scan after 3 cycles of neoadjuvant chemotherapy showing a 30% tumor size regression. The Annals of Thoracic Surgery 2011 91, 837-842DOI: (10.1016/j.athoracsur.2010.11.013) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Schematic view of the procedure showing the preserved right lower lobe (RLL) and the cryopreserved aortic allograft (CAA, red color) supported by the custom-made, fully covered conical self-expanding metallic stent (SEMS, black color) comprising an oblique distal segment (*) that allowed ventilation of all RLL bronchi, including the right lower lobe apical bronchus (RLLAB). The Annals of Thoracic Surgery 2011 91, 837-842DOI: (10.1016/j.athoracsur.2010.11.013) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Postoperative evaluation. (A) Chest X-ray at 9 months showing a fully reexpanded lower lobe of the right lung with ipsilateral diaphragmatic elevation due to normal adaptation to bilobectomy. (B) Computed tomography (CT) scan (coronal view) at 6 months showing the patency of the bronchial transplant (arrow) and the reimplanted bronchi. (C) Three-dimensional (3D) CT scan at 6 months showing the stented bronchial transplant (arrow) with the subjacent bronchial tree. (D) Virtual 3D CT bronchoscopy at 6 months showing the patency of the right main bronchus (RMB), the stented bronchial transplant (SBT), and the lower lobe bronchus (LLB). The Annals of Thoracic Surgery 2011 91, 837-842DOI: (10.1016/j.athoracsur.2010.11.013) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions