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1.
Cell Biochem Biophys ; 67(3): 949-55, 2013.
Article in English | MEDLINE | ID: mdl-23549737

ABSTRACT

We evaluated the clinico-surgical significance of pulmonary artery (PA) reconstruction using a patch of autologous pericardium/azygos venae substitute to treat central non-small cell lung cancer in 62 patients with pulmonary arteries invaded by tumor. According to TNM-classification, four patients were stage IIb, 46 were stage IIIa, and 12 were stage IIIb. Depending on tumor infiltration, surgical procedures included partial PA tangential resections/reconstructions by a patch of autologous azygos venae, a patch of autologous pericardium and complete PA sleeve resection and reconstruction by a custom-made autologous pericardial conduit interposition. 47 patients received postoperative chemotherapy and 19 received radiotherapy. There were 2 (3.2%) postoperative early deaths due to bronchial anastomotic leakage. Postoperative complications occurred in 17.7% (11/62) patients and all recovered uneventfully. Mean follow-up time after surgical resection was 49.5 (6-12) months and overall ≤1-, 3-, 5-, and ≥10-year survival rates were 80.2, 44.7, 31.4, and 23.1%, respectively. It was concluded that autologous pericardial patch and azygos vein patch reconstruction of PA were safe and effective. Regarding extended circumferential defects after sleeve resection in which end-to-end anastomosis is not feasible, autologous pericardial conduit interposition may be useful for reconstruction when a tumor extensively infiltrates full circumference of the PA.


Subject(s)
Carcinoma, Non-Small-Cell Lung/surgery , Lung Neoplasms/surgery , Pulmonary Artery/surgery , Adult , Aged , Azygos Vein/transplantation , Carcinoma, Non-Small-Cell Lung/diagnostic imaging , Carcinoma, Non-Small-Cell Lung/mortality , Female , Humans , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/mortality , Male , Middle Aged , Neoplasm Staging , Pericardium/transplantation , Pneumonectomy , Postoperative Complications , Plastic Surgery Procedures , Survival Rate , Tomography, X-Ray Computed , Transplantation, Autologous
2.
Gen Thorac Cardiovasc Surg ; 58(10): 524-7, 2010 Oct.
Article in English | MEDLINE | ID: mdl-20941566

ABSTRACT

A 5-month-old boy was presented for surgical repair of scimitar syndrome associated with right lung hyperplasia, severe pulmonary hypertension, ventricular septal defect (VSD), and atrial septal defect. The calculated shunt fraction (Qp/Qs) was 3.1:1.0, pulmonary vascular resistance was 4.6, and the perfusion lung scan showed a marked decrease (11%) in right pulmonary blood flow. Surgical repair was performed through the right fourth intercostal space with the patient supine. The anomalous vein was divided and interposed with a short azygos vein graft, followed by closure of the VSD. Finally, the interposed azygos vein was anastomosed to the left atrium. Although pulmonary artery pressure was normalized at the 2-year follow-up, cardiac catheterization 6 months after the operation demonstrated right pulmonary vein obstruction.


Subject(s)
Abnormalities, Multiple , Heart Septal Defects, Ventricular/complications , Hypertension, Pulmonary/etiology , Lung/abnormalities , Scimitar Syndrome/complications , Azygos Vein/transplantation , Blood Pressure , Cardiac Catheterization , Heart Septal Defects, Atrial/complications , Heart Septal Defects, Atrial/surgery , Heart Septal Defects, Ventricular/physiopathology , Heart Septal Defects, Ventricular/surgery , Humans , Hypertension, Pulmonary/physiopathology , Hypertension, Pulmonary/surgery , Infant , Lung/blood supply , Male , Perfusion Imaging , Pulmonary Circulation , Pulmonary Veno-Occlusive Disease/etiology , Scimitar Syndrome/physiopathology , Scimitar Syndrome/surgery , Treatment Outcome , Vascular Grafting/adverse effects , Vascular Resistance
5.
Interact Cardiovasc Thorac Surg ; 7(2): 192-4, 2008 Apr.
Article in English | MEDLINE | ID: mdl-18184676

ABSTRACT

Two patients with pulmonary atresia and ventricular septal defect underwent implantation of the diminutive pulmonary arteries on the ascending aorta by interposition of short segment of azygos and innominate veins. The very thin structure of the systemic veins' wall matched perfectly the fragile pulmonary arterial wall. The anastomosis were perfectly patent and no aneurism dilatation was evident after three and four months, respectively.


Subject(s)
Aorta/surgery , Azygos Vein/transplantation , Brachiocephalic Veins/transplantation , Cardiac Surgical Procedures , Heart Septal Defects, Ventricular/surgery , Pulmonary Artery/surgery , Pulmonary Atresia/surgery , Vascular Surgical Procedures , Anastomosis, Surgical , Aorta/pathology , Azygos Vein/diagnostic imaging , Brachiocephalic Veins/diagnostic imaging , Heart Septal Defects, Ventricular/complications , Heart Septal Defects, Ventricular/diagnostic imaging , Heart Septal Defects, Ventricular/physiopathology , Humans , Infant , Infant, Newborn , Pulmonary Artery/abnormalities , Pulmonary Artery/diagnostic imaging , Pulmonary Artery/physiopathology , Pulmonary Atresia/complications , Pulmonary Atresia/diagnostic imaging , Pulmonary Atresia/physiopathology , Radiography , Time Factors , Treatment Outcome , Vascular Patency
6.
Ann Thorac Surg ; 60(3): 729-33, 1995 Sep.
Article in English | MEDLINE | ID: mdl-7677520

ABSTRACT

Desmoplastic reactions secondary to adjuvant chemotherapy and radiation in stage IIIA lung cancer, plus advances in complex tracheobronchial surgery, have rejuvenated an interest for augmenting bronchial stump coverage and suture line reinforcement. We present the techniques and applications of harvesting pleural, azygos vein, pericardial flaps, and fat pad grafts, and intrathoracic transposition of chest wall muscle flaps.


Subject(s)
Azygos Vein/transplantation , Bronchi/surgery , Muscle, Skeletal/transplantation , Pericardium/transplantation , Pleura/transplantation , Pneumonectomy , Surgical Flaps/methods , Trachea/surgery , Adipose Tissue/transplantation , Chemotherapy, Adjuvant , Humans , Lung Neoplasms/therapy , Pneumonectomy/rehabilitation , Radiotherapy, Adjuvant , Suture Techniques
7.
J Pediatr Surg ; 25(7): 793-4, 1990 Jul.
Article in English | MEDLINE | ID: mdl-2380899

ABSTRACT

A tissue flap of azygous vein was successfully used for reinforcement of the esophageal anastomosis in two infants with wide-gap esophageal atresia and carinal tracheoesophageal fistula. In spite of anastomotic tension, both esophagi healed without leak or stricture. This technique may be of value in the surgical correction of esophageal anomalies.


Subject(s)
Azygos Vein/transplantation , Esophageal Atresia/surgery , Surgical Flaps/methods , Tracheoesophageal Fistula/surgery , Esophageal Atresia/complications , Female , Humans , Infant, Newborn , Tracheoesophageal Fistula/complications
8.
Ann Thorac Surg ; 48(6): 776-8, 1989 Dec.
Article in English | MEDLINE | ID: mdl-2596913

ABSTRACT

Hemodynamic repair in patients with pulmonary atresia, ventricular septal defect, hypoplastic pulmonary arteries with arborization defects, and major aortopulmonary collaterals necessitates prior unifocalization of pulmonary artery blood supply. When direct anastomosis between these collateral vessels and the central pulmonary arteries is not technically feasible, an interposition graft is required. Dacron, polytetrafluoroethylene, and pericardium have been used for this purpose. We describe our experience with the use of azygos vein as an interposition graft in 3 patients who underwent unifocalization of the pulmonary blood supply to the right lung. Our experience suggests that the azygos vein is a useful graft for use in this specific form of unifocalization procedure.


Subject(s)
Azygos Vein/transplantation , Blood Vessel Prosthesis , Heart Septal Defects, Ventricular/surgery , Pulmonary Artery/surgery , Pulmonary Valve/abnormalities , Aorta, Thoracic/surgery , Child, Preschool , Female , Humans , Infant , Male , Polytetrafluoroethylene
9.
Ann Thorac Surg ; 46(6): 686-7, 1988 Dec.
Article in English | MEDLINE | ID: mdl-3196105

ABSTRACT

Unexpected involvement of the superior vena cava with dense inflammatory and fibrous tissue was encountered during right pneumonectomy for a T3 N0 M0 squamous cell carcinoma. After expeditiously completing the lung resection, the azygos vein was utilized for a successful superior vena cava bypass.


Subject(s)
Azygos Vein/transplantation , Carcinoma, Squamous Cell/surgery , Lung Neoplasms/surgery , Vena Cava, Superior/surgery , Female , Humans , Middle Aged , Neoplasm Invasiveness , Phlebitis/surgery , Pneumonectomy
10.
Eur Surg Res ; 15(2): 79-91, 1983.
Article in English | MEDLINE | ID: mdl-6221929

ABSTRACT

24 adult dogs were randomly divided into 4 groups and submitted to angioplastic replacement of a 2- to 3-cm segment of the right or left pulmonary artery by three kinds of autogenous biomaterials; azygous vein, jugular vein and pericardium, and by a synthetic arterial prosthesis in a control group. In vivo evaluation was carried out by catheterization with a balloon catheter allowing successive intraluminal occlusion of the pulmonary branches, and by cineangiopneumography. There was a good correlation between evaluation techniques. Final evaluation after a follow-up of 5-20 months was based on postmortem measurement of the anastomosis diameter and histologic examination. In each group, the results were classified into four grades, numbered 0-3, and compared statistically. The results show that in this experimental model: (a) none of the autogenous tissues (selected for their potential ability to grow) proved better than the control Dacron arterial prosthesis, and (b) of the three biomaterials, the azygous vein was superior to the jugular vein and pericardium.


Subject(s)
Pulmonary Artery/surgery , Animals , Azygos Vein/transplantation , Blood Vessel Prosthesis , Dogs , Jugular Veins/transplantation , Pericardium/transplantation , Polyethylene Terephthalates , Transplantation, Autologous , Transplantation, Heterologous
11.
J Pediatr Surg ; 12(3): 287-94, 1977 Jun.
Article in English | MEDLINE | ID: mdl-874717

ABSTRACT

In the last decade, 14 patients underwent an aorticpulmonary shunt for cyanotic heart disease, at which time the subclavian artery was either deemed too small or too short to function satisfactorily as a Blalock shunt. In each case a rectangular piece of pericardium was excised, rolled into a tube, and sutured down one edge to create a tube graft. One end of the graft was sutured to the stump of the subclavian artery near its takeoff and the other end was sutured end-to-side to the corresponding pulmonary artery. During the same period, 5 children had azygos vein grafts and 2 had Teflon grafts inserted to create a modified Blalock shunt. This article will discuss the indications, techniques, and long term results of aorticpulmonary shunts of all types, and more specifically the complications and long term results in patients where these grafts were used.


Subject(s)
Heart Defects, Congenital/surgery , Pericardium/transplantation , Pulmonary Artery/surgery , Subclavian Artery/surgery , Adult , Azygos Vein/transplantation , Blood Vessel Prosthesis , Child , Child, Preschool , Humans , Infant , Infant, Newborn , Polytetrafluoroethylene , Transplantation, Autologous
12.
Surg Gynecol Obstet ; 141(6): 929-30, 1975 Dec.
Article in English | MEDLINE | ID: mdl-1188574

ABSTRACT

Interposition of the azygous vein between the subclavian and pulmonary artery is helpful in extending the subclavian artery, when additional length is required for a satisfactory anastomosis.


Subject(s)
Azygos Vein/transplantation , Subclavian Artery/surgery , Tetralogy of Fallot/surgery , Child, Preschool , Humans , Male , Pulmonary Artery/surgery , Transplantation, Autologous , Vascular Surgical Procedures/methods
13.
Ann Thorac Surg ; 20(4): 433-45, 1975 Oct.
Article in English | MEDLINE | ID: mdl-1180597

ABSTRACT

Blood flow to the right lung was reversed in 28 dogs, 14 of which survived more than 1 month. Four successful long-term survivors (1 years to 4 years 7 months) were repeatedly studied by cardiac catheterization, angiography, and ventilation/perfusion scans as well as hemodynamically when they were killed. Hemodynamics and gas transfer were normal up to 4 1/2 years after the procedure, and the histology of the right lung was essentially normal. The application of reversed pulmonary blood flow is proposed in the surgical management of forms of congenital heart disease in which the right ventricle is diminutive. The procedure consists of repartitioning of the atria to allow venous blood to flow into the lung through the pulmonary veins and exit to the left atrium through the pulmonary artery.


Subject(s)
Heart Defects, Congenital/surgery , Pulmonary Artery/surgery , Pulmonary Circulation , Pulmonary Veins/surgery , Animals , Azygos Vein/transplantation , Blood Vessel Prosthesis , Cardiac Catheterization , Dogs , Heart Atria/surgery , Hemodynamics , Jugular Veins/transplantation , Lung/pathology , Pulmonary Artery/diagnostic imaging , Pulmonary Veins/diagnostic imaging , Radiography , Transplantation, Autologous
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