Surgical Technique of Lower Lobe Lung Transplantation

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Presentation transcript:

Surgical Technique of Lower Lobe Lung Transplantation Tobias Deuse, MD, Bjoern Sill, MD, Patrick von Samson, MD, Yalin Yildirim, MD, Christian Kugler, MD, Maike Oldigs, MD, Hans Klose, MD, Stephan Meierling, MD, Klaus F. Rabe, MD, Hermann Reichenspurner, MD The Annals of Thoracic Surgery Volume 92, Issue 2, Pages e39-e42 (August 2011) DOI: 10.1016/j.athoracsur.2011.04.014 Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Back-table right upper and middle bilobectomy. The major fissure is completed (A) and the upper and middle lobes are removed while preserving the interlobar artery and the distal bronchus intermedius (B). A small cuff of left atrial tissue is preserved around the lower pulmonary vein. The Annals of Thoracic Surgery 2011 92, e39-e42DOI: (10.1016/j.athoracsur.2011.04.014) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Back-table left upper lobectomy. The upper lobe is retracted anteriorly and the fissure is completed (A). The interlobar artery is preserved and the lower lobe bronchus is divided at its take-off (B). The lower pulmonary vein is isolated with a small cuff. The Annals of Thoracic Surgery 2011 92, e39-e42DOI: (10.1016/j.athoracsur.2011.04.014) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Lower lobe implantation. The donor bronchus intermedius is connected to the recipient right main bronchus, the interlobar artery is anastomosed to the main pulmonary artery, and the lower donor vein is sewn to a left atrial recipient cuff. The Annals of Thoracic Surgery 2011 92, e39-e42DOI: (10.1016/j.athoracsur.2011.04.014) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 After implantation. The intraoperative picture (A) shows the left hilum after lobar implantation. (Br = bronchus, behind PA; PA= pulmonary artery; PV = pulmonary vein). Good size-matching is seen in the postoperative chest roentgenogram (B). The Annals of Thoracic Surgery 2011 92, e39-e42DOI: (10.1016/j.athoracsur.2011.04.014) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions