Experimental Lung Transplantation Using Non-Penetrating Vascular Clips for Anastomosis of the Pulmonary Artery

Background: Reliable and rapid anastomosis is critical in lung transplantation. The purpose of this study is to show the appropriateness of sutureless anastomosis of the pulmonary artery using a nonpenetrating vascular clipping device. Methods: The left lung was excised and the cranial lobe was transplanted autologously in 9 dogs. The anastomosis of the left main pulmonary artery (PA) (1 cm) was performed using a vascular clipping system. Results: PA anastomosis was performed in 7 dogs in 8 to 13 minutes. The endovascular surface of the anastomotic site was smooth, and passage of silicone rubber through the anastomosis was good 14 or 28 days after surgery. Microscopic examination of the anastomotic sites showed excellent healing without evidence of intimal hyperplasia. Conclusions: The vascular clipping system facilitates anastomosis of the PA in lung transplant surgery.

Lung transplantation - Pulmonary arterial anastomosis - Non-penetrating vascular clip - Sutureless anastomosis

References

• 1 Hammond St J, Kirsh W M, Whalstrom P GE. et al . A multicentered controlled clinical trial comparing clips to suture for construction of vascular access sites for hemodialysis.  Cardiovasc Surg.. 1995;  26.5 136
• 2 Nataf P, Kirsh W, Hill A C. et al . Nonpenetrating clips for coronary anastomosis.  Ann Thorac Surg.. 1997;  63 S135-7
• 3 Mital D, Foster P F, Jensik S C. et al . Renal transplantation without sutures using the vascular clipping system for renal artery and vein anastomosis - a new technique.  Transplantation.. 1996;  62 1171-3
• 4 Zhu Y H, Steckel R, Kirsh W M. Comparative evaluation of suture and nonpenetrating metal clips for vascular reconstruction.  Surg Forum.. 1994;  45 593-7
• 5 Pikoulis E, Burris D, Rhee P. et al . Rapid arterial anastomosis with titanium clips.  Am J Surg.. 1998;  175 494-6
• 6 Ishihara T, Nemoto E, Kikuchi K, Kato R, Kobayashi K. Does pleural bronchial wrapping improve wound healing in right sleeve lobectomy.  J Thorac Cardiovasc Surg.. 1985;  89 665-72
• 7 Kirsh W M, Zhu Y H, Hardesty R A, Chapolini R. A new method for microvascular anastomosis: report of experimental and clinical research.  Am Surgeon.. 1992;  58 722-7