Laser Doppler flowmetry detects early risk of tracheal anastomotic complications after lung transplantation.
Healing of tracheal anastomosis after en bloc double-lung or heart-lung transplantation was analysed with the aid of endoscopic laser Doppler flowmetry in 7 patients (group I) with successful bronchial artery revascularization (BAR) and in 5 patients (group II) without or with failed BAR. Fifteen patients undergoing coronary surgery served as a control group. Airway anastomotic index (AAI) was used to express the ratio of Doppler flowmetry values between donor and recipient airway. On postoperative day 1 the mean (range) AAI was 1.3 (1.1-1.6) in group I, 0.74 (0.25-1.0) in group II and 0.95 (0.7-1.4) in the controls.The difference was statistically significant between groups I and II (p = 0.01) and also between group I and the control group (p = 0.003). Two group II patients had low AAI (<0.5), and both developed airway anastomotic complications. We conclude that successful BAR increases blood flow in the airway anastomotic region, and that low AAI on the first postoperative day is a strong predictor of late airway anastomotic complications.
Hyytinen
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TA
Department of Thoracic and Cardiovascular Surgery, Helsinki University Central Hospital, Finland. timo.hyytinen@huch.fi
Halme
M
M
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D001980:Bronchi / Q000098:blood supply; D001981:Bronchial Arteries / Q000601:surgery*; D005260:Female; D016041:Heart-Lung Transplantation; D006801:Humans; D007511:Ischemia / Q000175:diagnosis; D017078:Laser-Doppler Flowmetry; D016040:Lung Transplantation; D008297:Male; D008833:Microcirculation / Q000503:physiopathology; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis*; D012016:Reference Values; D014132:Trachea / Q000601:surgery*; D014945:Wound Healing / Q000502:physiology