A CASE OF INTRA-OPERATIVE INJURY TO LEFT MAIN PULMONARY ARTERY REPAIRED WITH A PERICARDIAL PATCH

Introduction: Patients with central lung tumours often undergo surgery, offering them a chance of cure. With central lung tumours, there is always the dreaded risk of injury to the left main pulmonary artery (PA) and rupture of the anterior segmental artery, known as the artery of sorrow.

Case Presentation: A 75-year-old lady with a background of breast cancer presented to our cardiothoracic centre because computed tomography (CT) of the chest revealed a left lung lesion of 5 x 4 x 3.7 cm, in contact with oblique fissure, radiological staging T3 N2 M0, which was later shown to be highly avid on positron emission tomography (PET-CT). Resection via thoracotomy was done, due to dense attachment to PA, Left PA defect was noted after resection which was repaired with a pericardial patch with no post-operative complication.

Discussion: In the event of tumours invading the PA, it is safe to divide the tumours completely and repair the PA using a patch if there are any complications.

Conclusion: We performed a repair of the PA using a pericardial patch and reconstruction of the PA using a pericardial patch, and evidence shows that there is excellent long-term survival associated with this.