Carinal reconstruction under veno-venous bypass using a percutaneous cardiopulmonary bypass system

We report two patients who underwent carinal resection and reconstruction for advanced lung cancer under veno-venous bypass. The bypass system consisted of a centrifugal pump and a hollow-fiber membrane oxygenator, and was established by percutaneous insertion of cannulas through the femoral veins using the Seldinger technique. This respiratory support system under veno-venous bypass was safe and useful for carinal reconstruction, providing a good visual field and adequate oxygenation. Although other standard accepted ventilation techniques can be used for carinal resection, veno-venous bypass is an alternative adjunct in cases involving difficult carinal reconstruction.