Reconstruction surgery case report: ex vivo surgery and auto lung transplantation for pulmonary artery sarcoma

Daisuke Nakajima, Sou Miyahara, Hiroshi Date

Abstract

This is a report on the lung autotransplant techniques for the treatment of intimal sarcoma of pulmonary artery (PA). A 58-year-old man was diagnosed with PA sarcoma occluding the right main PA and peripherally extending into the right interlobar PA. First, the tumor was completely removed by pulmonary endarterectomy combined with right pneumonectomy under cardiopulmonary bypass. A following ex vivo evaluation of the explanted right lung revealed that the right lower PA was intraluminally intact, so the right lower lobe was used for reimplantation after being flushed with cold organ preservation solution on a back table. The patient was safely weaned from cardiopulmonary bypass following transplantation. His early post-transplant course was uneventful. He died of tumor recurrence at the distal left PA and liver and bone metastasis 14 months after surgery.