Pericardial Conduit for Pulmonary Artery Reconstruction by Surgical Stapling Noriyuki Matsutani, MD, Eiichi Kanai, DVM, Ryutaro Hanawa, MD, Yusuke Takahashi,

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Pericardial Conduit for Pulmonary Artery Reconstruction by Surgical Stapling Noriyuki Matsutani, MD, Eiichi Kanai, DVM, Ryutaro Hanawa, MD, Yusuke Takahashi, MD, Hirofumi Uehara, MD, Hisae Iinuma, MD, Masafumi Kawamura, MD The Annals of Thoracic Surgery Volume 103, Issue 5, Pages e469-e471 (May 2017) DOI: 10.1016/j.athoracsur.2016.11.073 Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (A) The pericardium is dissected in a rectangular shape along the phrenic nerve with the size of Y cm × X cm × Y cm, where one X cm side is left uncut. (B) The pericardium, with the epicardial layer facing inside, is placed outside a 24F chest tube. (C) The pericardium is longitudinally sutured using a surgical stapler. (D) The proximal side and distal sides of the pulmonary artery are retained by Satinsky clamps. (d = diameter of the pulmonary artery; X = the length of the pulmonary artery to be resected; Y = the length of the circumference of the pulmonary artery with the width of surgical stapling [1 cm × 2]: Y = d × 3.14 + 1 × 2.) The Annals of Thoracic Surgery 2017 103, e469-e471DOI: (10.1016/j.athoracsur.2016.11.073) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A) Four places are sutured using 5-0 polypropylene (Prolene, Ethicon, Somerville, NJ) sutures by the two point sutures proximal side and distal side of the pericardial conduit with the pulmonary artery; vascular anastomosis is performed using a continuous suture. (B) A relaxation incision is created, and the central part of the missing area in the pericardium is sutured together to prevent a cardiac hernia. The Annals of Thoracic Surgery 2017 103, e469-e471DOI: (10.1016/j.athoracsur.2016.11.073) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions