 Total Inversion of the Left Lung Circulation: Morphologic and Functional Analyses
(#1999-8595 ... )
Leonardo Andrade Mulinari1, André Luiz Tyszka2, Roberto Gomes de Carvalho2, Danton R. da Rocha Loures2, Luiz Felipe P. Moreira3, Noedir A.G. Stolf3
Heart Institute, Hospital das Clínicas, Medical School, University of São Paulo, Brazil
1Hospital de Clinicas, Paraná Federal University, Brazil
2 Hospital de Clinicas, Paraná Federal University, Brazil
3Heart Institute, Medical School, University of São Paulo
ABSTRACT
Background: An experimental model for total inversion of left lung circulation was developed. With this model, the authors demonstrate that it is possible to reverse the pulmonary circulation and preserve the normal function and morphology of the lung.
Methods: Eight dogs had their left pulmonary circulation reversed. The blood from the pulmonary artery trunk was diverted to the pulmonary veins, and returned from the pulmonary artery into the left atrium. In order to monitor the flow through the reversed system, color Doppler echocardiography was performed on the ninth postoperative day. The dogs were reoperated after 15 days for re-evaluation. Blood gas analyses from the aorta and the pulmonary artery were used to study the functional status of the lung in both operations. The morphology was studied by comparing biopsies of the lung performed before and after reversal of flow.
Results: Blood gas analysis showed no significant difference between the samples of from the aorta and pulmonary artery. Color Doppler echocardiography was a reliable method for the study of the inverted circulation. The histological study showed no differences in the morphology of the lung after the reversed circulation.
Conclusions: Left pulmonary circulation was fully reversed. Pulmonary function and morphology remained normal.
AUTHOR/ARTICLE INFORMATION
Reprint requests to: Leonardo A. Mulinari, Av. Silva Jardim 3722, apto. 4, Curitiba, PR, Brasil, Cep:80240-021
Submitted on: Translated and reproduced with permission from Revista Brasileira De Cirurgia Cardiovascular; 13(2): 162-7. Copyright 1998 Leonardo Andrade Mulinari, et al. Translated by Livia Burdmann.
Keywords: Pulmonary circulation, cytology, physiology, reversal, inverted, pulmonary hypertensions, pulmonary vascular obstructive disease, PVOD, primary pulmonary hypertension, PPH
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