Patch-closure of tracheal defects with pericardium/PTFE. A new technique in extended pneumonectomy with carinal...

Patch closure of a tracheal defect resulting from extended pneumonectomy including the main carina and a limited area of the lower trachea or the opposite bronchus is described in five cases of bronchogenic carcinoma and one case of metastatic melanoma. It was accomplished by the use of a PTFE soft-tissue patch and integrated pericardial flap. Airway continuity was satisfactorily restored in all but one case with a longest survival of 30 months. One patient developed an empyema and died from respiratory failure after 6 weeks. The method is technically easy and can serve as an alternative to resection of the whole bifurcation in selected cases. Intraoperative ventilation using double lumen tubes needs not be altered.