Anomalous Pulmonary Venous Return of the Left Upper Lobe in a Donor Lung Anne Olland, MD, MS, Jérémie Reeb, MD, Pierre-Emmanuel Falcoz, MD, PhD, Julien.

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Presentation transcript:

Anomalous Pulmonary Venous Return of the Left Upper Lobe in a Donor Lung Anne Olland, MD, MS, Jérémie Reeb, MD, Pierre-Emmanuel Falcoz, MD, PhD, Julien Garnon, MD, Philippe Germain, MD, Nicola Santelmo, MD, Romain Kessler, MD, PhD, Gilbert Massard, MD, PhD The Annals of Thoracic Surgery Volume 99, Issue 6, Pages 2199-2202 (June 2015) DOI: 10.1016/j.athoracsur.2014.07.085 Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Implantation of partial anomalous pulmonary venous return into the left atrial cuff. (A) Schematic overview of the initial condition of venous drainage of the left lung graft. The upper pulmonary vein is free, and the lower pulmonary vein is normally connected to the atrial cuff. An incision was made into the atrial cuff following the dotted line. (B) Intraoperative photograph during direct suture of the left upper vein into the atrial cuff. A running suture of 5/0 polypropylene was used. The atrial cuffed is exposed using several polypropylene stay sutures. (C) Schematic overview of the final result of reconstruction on the inside of the atrial cuff. (D) Photograph of the outside aspect of the left upper vein directly sutured into the atrial cuff. The outer aspect of the suture shows no tension and no stricture on the final calibre of the pulmonary vein. (E) Schematic overview of the final result during allograft implantation into the recipient. The Annals of Thoracic Surgery 2015 99, 2199-2202DOI: (10.1016/j.athoracsur.2014.07.085) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Three-dimensional reconstruction of the donor’s chest computed tomographic scan, showing the left upper pulmonary vein originating from the left upper lobe and draining into the innominate vein. The Annals of Thoracic Surgery 2015 99, 2199-2202DOI: (10.1016/j.athoracsur.2014.07.085) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Cardiac magnetic resonance imaging performed in the recipient to assess patency and function of the left upper venous drainage into the left atrium. The arrow designates the anomalous pulmonary vein. The Annals of Thoracic Surgery 2015 99, 2199-2202DOI: (10.1016/j.athoracsur.2014.07.085) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions