Anomalous Pulmonary Venous Return of the Left Upper Lobe in a Donor Lung

Transplantation of Donor Lung with Partial Anomalous Pulmonary Venous Return Using a Carrel Patch

Partial anomalous pulmonary venous return is a rare congenital aberrancy which involves oxygen-rich pulmonary venous drainage into the right atrium instead of systemic circulation. Here, we report a case of isolated partial anomalous pulmonary venous return of the right upper lobe in a donor lung. Successful transplantation was performed with a Carrel patch technique for left atrial cuff reconstruction using a segment of donor vena cava. This is the third report of partial anomalous pulmonary venous return in a right donor lung, but the first to describe this reconstructive approach to restore physiologic venous drainage.

Reconstruction of Donor Anomalous Pulmonary Vein During Lung Transplantation

Pulmonary vein anomalies are rare but can complicate lung transplantation especially if unrecognized during the lung procurement operation. We describe a case of a partial anomalous pulmonary venous return of a donor lung detected at the time of transplant reperfusion. The anomalous donor right upper pulmonary vein was successfully connected to the recipient atrial cuff using a bovine pericardium conduit constructed with a vascular stapler. This reconstruction has been durable, as it has remained patent for over 5 years.

Donor Pulmonary vein anomalies: What's in your toolbox?

Pulmonary vein anomalies are often unrecognized during donor lung procurement. Consequently, they are at high risk for injury and this leaves the implanting surgeon with an unpleasant surprise. An innovative approach can help resolve the situation. We wish to highlight our experience with an anomalous left upper pulmonary vein and describe a novel reconstruction technique.