Serial Bronchography following Pulmonary Autotransplantation

¹ Associate Professor of Radiology, Albert Einstein College of Medicine
² Departments of Diagnostic Radiology and Surgery of the Montefiore Hospital and Medical Center and Albert Einstein College of Medicine, New York City
³ Professor of Surgery, Albert Einstein College of Medicine

Plain chest roentgenography and bronchography were performed preoperatively and at weekly postoperative intervals following autotransplantation of the left lung in a group of five mongrel dogs. Transient bronchial narrowing was observed to originate at the bronchial anastomosis and to extend distally to involve major lobar bronchi. The caliber of the bronchial lumen at the site of the bronchial anastomosis ranged from 64 percent to 73 percent of baseline levels in the first postoperative week. Bronchial narrowing was attributed in part to the intraluminal protrusion of edematous bronchial mucosa. In the second week figures ranged between 80 percent and 86 percent of preoperative measurements. Bronchograms appeared normal after the fourth postoperative week. Observations of the bronchial lumen on oblique plain chest roentgenograms correlated well with findings on bronchography. Plain chest roentgenography is thus a reliable means of assessing the status of the bronchial anastomosis. In an uncomplicated reimplantation response one should observe progressive increase in the width of the bronchial lumen after the first postoperative week.