title: Pulmonary artery reconstruction by a custom-made heterologous pericardial conduit in the treatment of lung cancer.
abstract: Lung cancer may involve the pulmonary artery (PA) either by direct extension of the primary tumor or by invasion of the hilar lymph nodes. In these instances, a radical resection is usually a pneumonectomy despite distal functioning lung tissue. To spare the lung parenchyma, angioplastic procedures requiring removal of a portion of the arterial wall or a circumferential resection with arterial reconstruction have been used. Several techniques of pulmonary arterioplasty have been explored suggesting that the incidence of postoperative complications is acceptably low and long-term local control can be achieved. Over a period of 7 years, 84 angioplastic procedures (alone or associated with bronchoplasty) were performed at our institution. Partial PA resection was performed in 80 (95.2%) patients. Reconstruction was performed by running suture in 63 (75%) patients and using a pericardial patch in 17 (20.2%) cases (16 autologous and 1 heterologous). A complete PA resection and reconstruction was performed in four (4.8%) patients by a polytetrafluoroethylene (PTFE) prosthesis (n=2) and by a custom-made bovine pericardial conduit (n=2). The latter are the topic of this report.
authors.affiliation: Department of Thoracic Surgery, European Institute of Oncology, via Ripamonti 435, 20141 Milan, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Galetta
authors.forename: Giulia
authors.initials: G
authors.lastname: Veronesi
authors.forename: Francesco
authors.initials: F
authors.lastname: Leo
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Spaggiari
mesh_terms: D000368:Aged; D018287:Carcinoma, Large Cell / Q000601:surgery; D018278:Carcinoma, Neuroendocrine / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D020099:Coated Materials, Biocompatible / Q000627:therapeutic use; D004867:Equipment Design; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000295:instrumentation*; D011138:Polytetrafluoroethylene / Q000627:therapeutic use; D011651:Pulmonary Artery / Q000473:pathology* / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000295:instrumentation*
chemical_list: D020099:Coated Materials, Biocompatible; D011138:Polytetrafluoroethylene