Use of the aortic homograft in the reconstruction of complex tracheobronchial tree injuries

Background/Purpose: The repair of complex tracheobronchial tree injuries of ten is associated with complications including stenosis and excessive granu lation tissue formation. Patch reconstruction using pericardium or syntheti c material decreases the incidence of stenosis. The authors report on the u se of the ascending aorta cryopreserved homograft in reconstructing the tra cheobronchial tree of three children. Results: A 10 year old had a through-and-through gun shot wound to the left main stem bronchus with cartilaginous loss. A 12 year old double lung tran splant recipient had a breakdown of one bronchial anastomosis after stent p lacement. A 1 year old had an acquired tracheoesophageal fistula secondary to a long standing foreign body. In all three patients, the aortic patches were secured with interrupted sutures. All three had uneventful recoveries, and postoperative bronchoscopy showed the patches to be completely covered with epithelium without stenosis or granulation tissue. Conclusions: This is the first report of the use of the cryopreserved ascen ding aorta homograft in the reconstruction of the tracheobronchial tree. Th e homograft is strong yet malleable. It gets completely covered with epithe lium and results in no stenosis because of the lack of tension. These chara cteristics make it an attractive alternative for the patch reconstruction o f complex tracheobronchial tree injuries. Copyright (C) 1999 by W.B. Saunde rs Company.