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J Thorac Cardiovasc Surg 1994;108:993
© 1994 Mosby, Inc.

LETTERS TO THE EDITOR

Invited letter concerning: Double lung transplantation in situs inversus with Kartagener's syndrome

Philippe Dartevelle, MD, Paolo Macchiarini, MD

Department of Thoracic and Vascular Surgery
and Heart-Lung Transplantation
Hôpital Marie-Lannelongue (Paris-Sud University)
133, Avenue de la Resistance
92350 Le Plessis Robinson, France

Reply to the Editor:

We appreciate Dr. Baldwin's comments on our technique of double lung transplantation in situs inversus with Kartagener's syndrome. We entirely share his opinions on the superiority of heart-lung transplantation in preserving the coronary-bronchial collateral perfusion of the donor airways, and we agree that ischemic airway complications are unusual in this type of transplantation, which still represents the most pertinent procedure for a variety of end-stage parenchymal and vascular pulmonary diseases, including Kartagener's syndrome. We are also convinced that patients' risks of early and long-term complications with the donor heart are negligible, but organ economy is a major concern whose importance is escalating world wide. In this sense, double lung transplantation offers a unique advantage to expand and optimize the donor organ pool. With refinement of the available double lung transplantation proceduresGo 1 and related developing surgical skills,Go 2 airway complications should significantly decline.

References

  1. Cooper JD, Patterson AG, Trulock EP, the Washington University Lung Transplantation Group. Results of single and bilateral lung transplantation in 131 consecutive patients. J THORAC CARDIOVASC SURG 1994;107:460-71.
  2. Patterson GA. Airway revascularization: Is it necessary? Ann Thorac Surg 1993;56:807-8.




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