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J Thorac Cardiovasc Surg 2008;136:525-527
© 2008 The American Association for Thoracic Surgery

Brief Communication

Superficial femoral vein as substitute for pulmonary artery reconstruction after resection for bronchovascular fistula

^a Division of Thoracic and Vascular Surgery, University Hospital of Lausanne, Lausanne, Switzerland
^b Division of Oto-Rhino-Laryngology, University Hospital of Lausanne, Lausanne, Switzerland
^c Division of Anesthesiology, University Hospital of Lausanne, Lausanne, Switzerland

Received for publication August 15, 2007; accepted for publication October 2, 2007.

^_* Address for reprints: Hans-Beat Ris, MD, Centre Hospitalier Universitaire Vaudois, Service de Chirurgie Thoracique et Vasculaire, Rue du Bugnon 46, 1011 Lausanne, Switzerland.

The first 20% of the full text of this article appears below.

Post-lobectomy bronchovascular fistula (BVF) associated with massive hemoptysis is a rare but life-threatening complication. Surgical options include completion pneumonectomy or BVF resection with end-to-end anastomosis of the airways and reconstruction of the pulmonary artery (PA) by interposition of an appropriate substitute. We report PA resection and successful reconstruction by interposition of an autologous reversed superficial femoral vein (SFV) segment for this purpose.

Clinical Summary

A 59-year-old man with a history of coronary stenting for coronary artery disease underwent uncomplicated intrapericardial left upper lobectomy after radiochemotherapy (60 Gy) for non–small cell lung cancer. Two months later, cataclysmal hemoptysis developed in the patient, requiring cardiopulmonary reanimation, bedside rigid bronchoscopy, selective intubation, and stabilization in the intensive care unit. Bronchoscopy and computed tomography scan revealed a BVF between the PA and the bronchial stump ( Figure 1), and surgical reintervention was considered. Posterolateral left thoracotomy was performed, and the left PA was clamped proximally and distally. Exploration confirmed the localization of the fistula between the left PA and the bronchial stump. Pneumonectomy seemed prohibitive . . . [Full Text of this Article]

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