Influence of Surgical Technique on the Results of Pulmonary Reimplantation

The left lung was reimplanted in 94 mongrel dogs with an operative mortality rate of 36 percent. Avoidable technical factors were found to be responsible not only for the majority of operative deaths but also for the defective anastomoses in 45 of the 60 surviving animals. Narrowing of the vascular anastomoses was related to suture technique and accounted for the minority of complications. Bronchial necrosis and its sequelae were the predominant causes of a defective reimplanted lung and could be minimizd by maintaining a long proximal bronchial stump with an intact blood supply. The use of interrupted sutures to approximate the cartilaginous portions of the bronchus proved to be superior to a continuous suture technique.