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J Thorac Cardiovasc Surg 2008;136:1372-1374
© 2008 The American Association for Thoracic Surgery

Brief Communication

Pumpless extracorporeal gas exchange aiding central airway surgery

Thorsten Walles, MDa,*, Volker Steger, MDa, Holger Wurst, MDb, Klaus-Dieter Schmidt, MDb, Godehard Friedel, MDa

a Department of Thoracic Surgery, Schillerhöhe Hospital, Gerlingen, Germany
b Department of Anesthesiology, Schillerhöhe Hospital, Gerlingen, Germany

Received for publication November 4, 2007; accepted for publication December 24, 2007.

* Address for reprints: Thorsten Walles, MD, Department of Thoracic Surgery, Schillerhöhe Hospital, Solitudestrasse 18, D-70839 Gerlingen, Germany. (Email: twalles@yahoo.com).

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

In the setting of tracheobronchial resection and reconstruction, skilled coordination between surgeons and anesthesiologists is mandatory. However, tubing lines traversing the operating field, splashing liquids caused by tracheal gas flows, and thoracic excursions caused by artificial ventilation complicate the surgical procedure, especially when microsurgical techniques are applied.1Go Therefore, during surgery pulmonary ventilation may be replaced temporarily by alternative oxygenation techniques that are limited by the rise in arterial partial pressure of carbon dioxide (PaCO 2).2Go The development of a new generation of low-resistance oxygenator membranes paved the way for pumpless extracorporeal lung assist (pECLA) devices that operate without expensive equipment and the expenses for trained staff.3Go Because of our clinical pECLA experience in patients with acute lung failure, we applied this technology intraoperatively to afford the reconstruction of an extensive tracheoesophageal defect.

Clinical Summary

A 63-year-old man was admitted for defect closure of an extensive esophagotracheal defect that had developed following laryngectomy and suprajugular tracheostomy by a bioartificial vascularized esophagotracheal patch.4Go The patient was unable to eat or drink . . . [Full Text of this Article]






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