An Aberrant Donor Pulmonary Vein During Lung Transplant: A Surgical Challenge

Optimal venous drainage for the pulmonary allograft: The search goes on

“…7 In this issue of the Journal, the lung transplant group from Kyoto University describes a successful technique of separate venous anastomoses of the inferior pulmonary vein to the common venous trunk and superior pulmonary vein to the left atrial appendage. Their case report adds to the series of similar techniques described in 2 reports by Massad and colleagues 8 and Khasati and colleagues 9 for complete left allograft drainage through the left atrial appendage in a donor with a single pulmonary vein. Because pulmonary venous anastomotic problems significantly contribute to patient morbidity and mortality, 10 the knowledge that several variations in the technique can be safely and successfully used provides a level of reassurance to the lung transplant surgeon.…”

Reconstruction of pulmonary venous conduit with CorMatrix in lung transplant

“…3 In situations where exposure of the native left pulmonary venoatrial connection is difficult, direct anastomosis of the pulmonary vein to the left atrial appendage has also been used. 4,5 CorMatrix is a decellularized porcine small intestinal submucosa-derived extracellular matrix that is approved by the US Food and Drug Administration for intracardiac and extracardiac use in humans. Its application in congenital cardiac reconstructive procedures includes superior vena cava, aortic, and pulmonary arterial patching, with encouraging short-term results, characterized by its strength, ease of use, hemostatic properties, flexibility, and lack of calcification or shrinkage.…”

“…3 In situations where exposure of the native left pulmonary venoatrial connection is difficult, direct anastomosis of the pulmonary vein to the left atrial appendage has also been used. 4,5…”

Combined bronchial sleeve resection and repair of partial anomalous pulmonary venous return

“…3 There have been reports of pulmonary venous anatomic variants recognized at the time of thoracic surgical procedures. Khasati and colleagues 4 report what was likely an anomalous left superior pulmonary vein that required anastomosis to the left atrial appendage at the time of lung transplantation. Sakurai and associates 5 reported repair of a right PAPVR, followed by a left pneumonec-tomy 3 weeks later for lung cancer.…”