Nervin Fanous, MD, S. Adil Husain, MD, Mark Ruzmetov, MD, PhD, Mark D

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Anterior pericardial tracheoplasty for long-segment tracheal stenosis: Long-term outcomes Nervin Fanous, MD, S. Adil Husain, MD, Mark Ruzmetov, MD, PhD, Mark D. Rodefeld, MD, Mark W. Turrentine, MD, John W. Brown, MD The Journal of Thoracic and Cardiovascular Surgery Volume 139, Issue 1, Pages 18-25 (January 2010) DOI: 10.1016/j.jtcvs.2009.09.040 Copyright © 2010 Terms and Conditions

Figure 1 Anterior pericardial tracheoplasty was performed through a median sternotomy during partial normothermic cardiopulmonary bypass. Three to 4 tacking sutures were placed to prevent future tracheomalacia from recoil, and harvested fresh autologous pericardium was tailored to enlarge the tracheal lumen to 1.5 times the predicted diameter. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 18-25DOI: (10.1016/j.jtcvs.2009.09.040) Copyright © 2010 Terms and Conditions

Figure 2 The pericardium was sutured to the tracheal edge with a continuous running 6-0 polydioxanone suture. Care was taken to avoid exposure of any suture material to the lumen of the airway in an attempt to minimize the subsequent formation of granulation tissue. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 18-25DOI: (10.1016/j.jtcvs.2009.09.040) Copyright © 2010 Terms and Conditions

Figure 3 Several tacking sutures were used to suspend the pericardium anteriorly to the surrounding mediastinal structures. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 18-25DOI: (10.1016/j.jtcvs.2009.09.040) Copyright © 2010 Terms and Conditions

Figure 4 Postmortem tracheal analysis depicting incorporation of pericardial patch: horizontal section of the trachea showing the improved tracheal lumen. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 18-25DOI: (10.1016/j.jtcvs.2009.09.040) Copyright © 2010 Terms and Conditions

Figure 5 Biopsy specimen of the epithelium overlying granulation tissue at the site of the pericardial patch demonstrating ciliated pseudostratified columnar epithelium. (Hematoxylin and eosin stain; original magnification 40×.) The Journal of Thoracic and Cardiovascular Surgery 2010 139, 18-25DOI: (10.1016/j.jtcvs.2009.09.040) Copyright © 2010 Terms and Conditions