Surgical Treatment of Pulmonary Artery Sling and Tracheal Stenosis

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Presentation transcript:

Surgical Treatment of Pulmonary Artery Sling and Tracheal Stenosis Andrew C. Fiore, MD, John W. Brown, MD, Thomas R. Weber, MD, Mark W. Turrentine, MD The Annals of Thoracic Surgery Volume 79, Issue 1, Pages 38-46 (January 2005) DOI: 10.1016/j.athoracsur.2004.06.005 Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 The anomalous left pulmonary artery (LPA) is seen arising from the right pulmonary artery (RPA) and coursing between the esophagus and the trachea. Associated trachea stenosis and the ductus arteriosus are illustrated. (MPA = main pulmonary artery.) The Annals of Thoracic Surgery 2005 79, 38-46DOI: (10.1016/j.athoracsur.2004.06.005) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 The ductus arteriosus is divided and the anomalous left pulmonary artery (LPA) is detached from the right pulmonary artery (RPA) and reimplanted into the main pulmonary artery (MPA) using absorbable suture. The Annals of Thoracic Surgery 2005 79, 38-46DOI: (10.1016/j.athoracsur.2004.06.005) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Autologous pericardial patch tracheoplasty. The pericardial patch is secured to the trachea using continuous absorbable suture avoiding the tracheal mucosa. The Annals of Thoracic Surgery 2005 79, 38-46DOI: (10.1016/j.athoracsur.2004.06.005) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Slide tracheoplasty. (A) The trachea is divided and the most stenotic segment is excised. (B) The proximal and distal limbs are opened and spatulated as illustrated. The arrows represent the technique of sliding the proximal and distal trachea segments over each other. (C) The spatulated end-to-end anastomosis is performed with interrupted absorbable suture taking bites to avoid the mucosa (see inset). The Annals of Thoracic Surgery 2005 79, 38-46DOI: (10.1016/j.athoracsur.2004.06.005) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions