Pericardial flap-plasty for protection of the tracheal anastomosis in heart-lung transplantation.

Infection or dehiscence of the tracheal anastomosis remains a dreaded and almost always fatal complication following heart-lung transplantation (HLTX). A technique of pericardial flap-plasty combined with application of fibrin sealant and topical antibiotics was developed and applied in three patients undergoing HLTX. The method allows for safe protection of the anastomosis even in the presence of severe ischemia and partial necrosis of the donor trachea at the same time avoiding laparotomy for mobilization of the omentum.