Shinya Unai MD, James Yun MD, PhD, Gösta B. Pettersson MD, PhD
{"title":"Bronchial Artery Revascularization: Surgical Technique","authors":"Shinya Unai MD, James Yun MD, PhD, Gösta B. Pettersson MD, PhD","doi":"10.1053/j.optechstcvs.2022.11.004","DOIUrl":null,"url":null,"abstract":"<div><p>The lung transplant community has long ignored the importance of bronchial arterial blood supply. We review relevant history, published articles addressing post-transplant ischemia, and single-center reports of lung transplant with bronchial artery revascularization (BAR), followed by details of surgical technique. In our experience, although BAR requires cardiopulmonary bypass (CPB) and there is increased risk of bleeding, ischemic time was shorter and length of ICU and hospital stays were similar. Technical success was achieved in > 95% of cases, which guarantees normal airway healing. Lung transplant with BAR is safe, reproducible, and may provide benefits beyond airway healing, with potential for decreasing BOS/CLAD and improving long-term survival. Multicenter study and long-term follow-up are needed.</p></div>","PeriodicalId":35965,"journal":{"name":"Operative Techniques in Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Operative Techniques in Thoracic and Cardiovascular Surgery","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1522294222001234","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 1
Abstract
The lung transplant community has long ignored the importance of bronchial arterial blood supply. We review relevant history, published articles addressing post-transplant ischemia, and single-center reports of lung transplant with bronchial artery revascularization (BAR), followed by details of surgical technique. In our experience, although BAR requires cardiopulmonary bypass (CPB) and there is increased risk of bleeding, ischemic time was shorter and length of ICU and hospital stays were similar. Technical success was achieved in > 95% of cases, which guarantees normal airway healing. Lung transplant with BAR is safe, reproducible, and may provide benefits beyond airway healing, with potential for decreasing BOS/CLAD and improving long-term survival. Multicenter study and long-term follow-up are needed.
期刊介绍:
Operative Techniques in Thoracic and Cardiovascular Surgery provides richly illustrated articles on techniques in thoracic and cardiovascular surgery written by renowned surgeons. Each issue presents cardiothoracic topics in adult cardiac, congenital, and general thoracic surgery. Each specialty of interest to the thoracic and cardiovascular surgeon is explored through two different approaches to a specific surgical challenge. Each article is thoroughly illustrated with original line drawings, actual intraoperative photos, and supporting tables and graphs.