Differences between flow profiles of pulmonary vein anastomoses affected by peripheral atelectasis in cadaveric and bilateral living-donor lobar lung transplantations.
We report two cases of peripheral atelectasis during cadaveric and living-donor lobar lung transplantation, which had different effects on the flow profile of pulmonary vein (PV) anastomoses. In the patient who underwent living-donor lobar lung transplantation, we detected the increase in the velocity of blood flow through the left PV anastomosis by intraoperative transesophageal echocardiography. Then peripheral atelectasis occurred in the transplanted left lung lobe. On the other hand, in the patient who underwent cadaveric bilateral lung transplantation, peripheral atelectasis occurred, but no changes in velocities of blood flow through PV anastomoses were detected by intraoperative transesophageal echocardiography. This difference may have been caused by the difference in sizes of pulmonary beds of transplanted grafts. These findings indicate the necessity of careful monitoring of PV anastomoses, especially in cases of living-donor lobar lung transplantation.
Miyaji
Katsumasa
K
Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine and Dentistry, Japan. kmiyaji@md.okayama-u.ac.jp
Matsubara
Hiromi
H
Nakamura
Kazufumi
K
Maruo
Takeshi
T
Morita
Hiroshi
H
Saito
Hironori
H
Kusano
Kengo F
KF
Emori
Tetsuro
T
Goto
Keiji
K
Date
Hiroshi
H
Ohe
Tohru
T
D000328:Adult; D001163:Arteriovenous Anastomosis / Q000000981:diagnostic imaging*; D001783:Blood Flow Velocity; D002102:Cadaver; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D019520:Living Donors; D016040:Lung Transplantation / Q000009:adverse effects*; D008297:Male; D001261:Pulmonary Atelectasis / Q000000981:diagnostic imaging* / Q000209:etiology; D011667:Pulmonary Veins / Q000000981:diagnostic imaging* / Q000473:pathology