Laser Doppler flowmetry detects early risk of tracheal anastomotic complications after lung transplantation

Healing of tracheal anastomosis after en bloc double-lung or heart-lung tra nsplantation was analysed with the aid of endoscopic laser Doppler flowmetr y in 7 patients (group I) with successful bronchial artery revascularizatio n (BAR) and in 5 patients (group II) without or with failed BAR. Fifteen pa tients undergoing coronary surgery served as a control group. Airway anasto motic index (AAI) was used to express the ratio of Doppler flowmetry values between donor and recipient airway. On postoperative day 1 the mean (range ) AAI was 1.3 (1.1-1.6) in group I, 0.74 (0.25-1.0) in group II and 0.95 (0 .7-1.4) in the controls. The difference was statistically significant betwe en groups I and II (p = 0.01) and also between group I and the control grou p (p = 0.003). Two group II patients had low AAI (<0.5), and both developed airway anastomotic complications. We conclude that successful BAR increase s blood flow in the airway anastomotic region, and that low AAI on the firs t postoperative day is a strong predictor of late airway anastomotic compli cations.