title: Pulmonary artery reconstruction with pulmonary vein conduit for lung cancer: medium-term results.
abstract: BACKGROUND
  The use of an autologous pulmonary vein (PV) conduit for reconstruction of the pulmonary artery (PA) in lung-sparing resections was first described in 2009, but to date only two case reports appeared and no medium-term and long-term results have been reported, to our knowledge. We present the first case series with medium-term follow-up.
  
  
  METHODS
  Between December 2009 and December 2012, 9 patients undergoing PA sleeve resection for centrally located lung cancer received reconstruction by this technique. Three of these patients underwent induction chemotherapy. The venous graft was obtained from the proximal extraparenchymal portion of the superior PV and was sutured to the proximal and distal PA stumps with the standard anastomotic technique.
  
  
  RESULTS
  All 9 patients underwent left upper lobectomy with sleeve resection of the PA without associated bronchoplasty. The postoperative morbidity rate was 33% (1 chylothorax, 1 atrial fibrillation, and 1 parenchymal atelectasis). No adverse events related to the reconstructive procedure occurred. There was no postoperative mortality. Complete patency of the reconstructed PA was shown in all patients by postoperative contrast computed tomography every 6 months. All patients are alive at a mean follow-up time of 32 ± 12.4 months (range, 6 to 42 months). Tumor recurrence has been observed in 2 patients (1 local, 1 systemic). The median survival time is 38 months. The median disease-free survival time is 33 months.
  
  
  CONCLUSIONS
  Reconstruction of the PA by a PV graft is a feasible and effective option for parenchymal-sparing resections. The PV conduit shows tissue characteristics similar to those of the arterial wall. This technique is safe and is supported by good medium-term results.
authors.affiliation: Department of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University, Rome, Italy. Electronic address: adandrilli@hotmail.com.
authors.forename: Antonio
authors.initials: A
authors.lastname: D'Andrilli
authors.affiliation: Department of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University, Rome, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Maurizi
authors.affiliation: Department of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University, Rome, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Andreetti
authors.affiliation: Department of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University, Rome, Italy.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Ciccone
authors.affiliation: Department of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University, Rome, Italy.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Ibrahim
authors.affiliation: Department of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University, Rome, Italy.
authors.forename: Camilla
authors.initials: C
authors.lastname: Poggi
authors.affiliation: Department of Thoracic Surgery, Policlinico Umberto I, Sapienza University, Rome, Italy; Lorillard Spencer Cenci Foundation, Rome, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Venuta
authors.affiliation: Department of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University, Rome, Italy; Lorillard Spencer Cenci Foundation, Rome, Italy.
authors.forename: Erino A
authors.initials: EA
authors.lastname: Rendina
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000601:surgery*; D011667:Pulmonary Veins / Q000637:transplantation*; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000379:methods