Pulmonary venous drainage into the left atrial appendage facilitates transplantation of the left lung with difficult exposure

Heterotopic implantation of the pulmonary venous confluence into the left a trial appendage during left lung transplantation is a reasonable alternativ e technique to reestablish venous drainage when exposure of the native left pulmonary veno-atrial connection may be problematic. We used this approach in a 39-year-old woman with chronic bronchiectasis who underwent bilateral sequential lung transplantation through a clam-shell approach. Dense hilar scarring and a small left atrial size made exposure of the native left pul monary veno-atrial connection difficult. (C) 2001 by The Society of Thoraci c Surgeons.