HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Vouhe, P. R. Articles by Dartevelle, P. G. Search for Related Content PubMed PubMed Citation Articles by Vouhe, P. R. Articles by Dartevelle, P. G.

The Journal of Thoracic and Cardiovascular Surgery, Vol 97, 906-910, Copyright © 1989 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Heart-lung transplantation. Technical modifications that may improve the early outcome

PR Vouhe and PG Dartevelle
Department of Cardiac Surgery, Hopital Laennec, Paris, France.

After heart-lung transplantation, mortality and morbidity remain related, to a significant degree, to surgical problems such as uncontrollable bleeding, phrenic nerve palsy, and dehiscence of the tracheal anastomosis. The following modifications of the original Stanford technique were designed: (1) Back bleeding from the graft is avoided; (2) dissection of the posterior mediastinum is limited as much as possible, with only the tracheobronchial bifurcation being dissected free; (3) surgical stapling is extensively used to optimize hemostasis; (4) the surgical procedure is kept away from the phrenic and vagus nerves; (5) early corticosteroid therapy is avoided and the tracheal anastomosis may be wrapped with a pedicle of great omentum. These techniques were used in 21 patients. Postoperative bleeding remained minimal and never necessitated reoperation. There was no instance of phrenic nerve palsy. Dehiscence of the tracheal anastomosis occurred in two patients during the initial experience, but in subsequent patients this complication was prevented by adequate improvements (omentoplasty and avoidance of corticosteroids). Our technical modifications may reduce the risk of early surgical complications and thereby improve the early outcome and leave the patient in better condition to face the other hazards of heart-lung transplantation.

This article has been cited by other articles:

				E. Fadel, O. Mercier, S. Mussot, F. Leroy-Ladurie, J. Cerrina, A. Chapelier, G. Simonneau, and P. Dartevelle Long-term outcome of double-lung and heart-lung transplantation for pulmonary hypertension: a comparative retrospective study of 219 patients Eur J Cardiothorac Surg, September 1, 2010; 38(3): 277 - 284. [Abstract] [Full Text] [PDF]

				P. Macchiarini, F. Le Roy Ladurie, J. Cerrina, E. Fadel, A. Chapelier, and P. Dartevelle Clamshell or sternotomy for double lung or heart-lung transplantation? Eur J Cardiothorac Surg, March 1, 1999; 15(3): 333 - 339. [Abstract] [Full Text] [PDF]

				T. B. Icenogle and J. G. Copeland A TECHNIQUE TO SIMPLIFY AND IMPROVE EXPOSURE IN HEART-LUNG TRANSPLANTATION J. Thorac. Cardiovasc. Surg., December 1, 1995; 110(6): 1590 - 1593. [Abstract] [Full Text]

				P. Macchiarini, A. Chapelier, P. Vouhe, J. Cerrina, F. Le Roy Ladurie, F. Parquin, F. Brenot, G. Simonneau, P. Dartevelle, and for the Paris-Sud University Lung Transplant Group Double lung transplantation in situs inversus with Kartagener's syndrome J. Thorac. Cardiovasc. Surg., July 1, 1994; 108(1): 86 - 91. [Abstract] [Full Text]

				I. W. Colquhoun, A. D. Gascoigne, J. Au, P. A. Corrins, C. J. Hilton, and J. H. Dark Airway complications after pulmonary transplantation Ann. Thorac. Surg., January 1, 1994; 57(1): 141 - 145. [Abstract] [PDF]

				J. Au, T. Hawkins, C. Venables, G. Morritt, C. D. Scott, A. D. Gascoigne, P. A. Corris, C. J. Hilton, and J. H. Dark Upper gastrointestinal dysmotility in heart-lung transplant recipients Ann. Thorac. Surg., January 1, 1993; 55(1): 94 - 97. [Abstract] [PDF]

				R. J. Novick, A. H. Menkis, F. N. McKenzie, K. R. Reid, P. W. Pflugfelder, W. J. Kostuk, and D. Ahmad The safety of low-dose prednisone before and immediately after heart-lung transplantation Ann. Thorac. Surg., April 1, 1991; 51(4): 642 - 645. [Abstract] [PDF]