Reconstruction of the pulmonary artery in patients with lung cancer (original) (raw)

we performed 17 resections and reconstructions of the pulmonary artery (PA) in patients with lung cancer. Three patients with intrapericardial infiltration of the PA underwent left pneumonectomy and PA angioplasty through a median sternotomy during cardiopulmonary bypass. The first patient survived in excellent general health for 25 months and then died of brain metastases; the second died of bronchopneumonia on postoperative day 24; and the third died of generalized tumor spread after 3 months. Fourteen patients had extrapericardial infiltration of the PA. They underwent sleeve upper lobectomy and PA reconstruction instead of pneumonectomy. In 6 patients we performed a sleeve resection of the PA, and he first report concerning resection and reconstruction T of the pulmonary artery (PA) in a patient with lung cancer was made by Allison in 1952 [l]. During the next three decades, a limited number of cases were reported in different series [2-4], but PA reconstructive procedures did not attain popularity among thoracic surgeons because of technical difficulties and increased postoperative complications. In 1985, Toomes and Vogt-Moykopf [5] presented a large series of PA reconstructive procedures with good long-term results; they affirmed that reconstruction is an advantageous alternative to pneumonectomy in select patients. However, the mortality and postoperative complication rates were high in their series. At present, some authors [6] prefer pneumonectomy over PA sleeve resection because of the increased operative risk of the latter; others [7] favor PA reconstruction because it offers them lower morbidity and mortality.