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J Thorac Cardiovasc Surg 2010;140:242-243
© 2010 The American Association for Thoracic Surgery

Brief Technique Report

Is pneumonectomy mandatory after transection of the left main pulmonary artery?

Ugonna N. Ihekweazu, BSa, William D. Travis, MDb, Raja M. Flores, MDb,*

a Division of Thoracic Surgery, Weill Cornell Medical College, New York, NY
b Division of Thoracic Surgery, Memorial Sloan–Kettering Cancer Center, New York, NY

Received for publication June 30, 2009; revisions received July 28, 2009; accepted for publication August 2, 2009.

* Address for reprints: Raja M. Flores, MD, Thoracic Service, Department of Surgery, Memorial Sloan–Kettering Cancer Center, 1275 York Ave, Room C-879, New York, NY 10021. (Email: floresr@mskcc.org).

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


   Introduction
 
Transection of the main pulmonary artery (PA) is thought to be associated with necrosis of the lung, subsequent sepsis, and death. We report the management of a patient from an outside hospital who underwent an aborted pneumonectomy after transection of the left main PA. We eventually treated the patient with an intrapericardial pneumonectomy. However, the patient was always clinically well, and after pneumonectomy, pathology did not reveal signs of significant necrosis. Therefore, it is possible that a ligated PA is compatible with life.


   Clinical Summary
 
A 44-year-old woman presented to an outside hospital with a large squamous cell carcinoma occluding the left mainstem bronchus. Results of mediastinoscopy and bone scanning were negative for metastasis.

At thoracotomy, the left main PA was completely divided distal to the ligamentum arteriosum (Figure 1 ). However, on further inspection of the . . . [Full Text of this Article]


Related Article

Difference in outcome in the transection of the pulmonary artery and vein
Mitsuhiro Kamiyoshihara, Toshiteru Nagashima, and Hitoshi Igai
J. Thorac. Cardiovasc. Surg. 2011 141: 306. [Extract] [Full Text] [PDF]



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 J. Thorac. Cardiovasc. Surg.Home page
M. Kamiyoshihara, T. Nagashima, and H. Igai
Difference in outcome in the transection of the pulmonary artery and vein
J. Thorac. Cardiovasc. Surg., January 1, 2011; 141(1): 306 - 306.
[Full Text] [PDF]


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