Early bronchial revascularization with an intercostal pedicle graft following canine lung autotransplantation

The contribution of an intercostal pedicle flap to early revascularization and healing of the bronchial anastomosis following lung autotransplantation was evaluated in dogs. Left lung reimplantation was performed both in 33 control dogs (group 1) and in 38 dogs in which a pedicled intercostal muscle graft was wrapped around the bronchial anastomosis (group 2). Radiologic injection studies, estimation of the cross-sectional area of the anastomosis and histologic examination to assess the degree of healing were made at autopsy - 7, 14 and 28 days respectively after transplantation. Within a week, the bronchial mucosa was more normal and the anastomosis substantially more patent in group 2 than in group 1 animals. This study indicates that the intercostal pedicle flap significantly improves bronchial healing by promoting revascularization across and beyond the bronchial anastomosis at least as early as 7 days after lung reimplantation.