Successful revascularization of totally ischemic bronchial autografts with omental pedicle flaps in dogs.

In 10 dogs, the left lung was removed and a closed stump of bronchus, comprising the distal main and lobar bronchi, was reanastomosed to the main bronchus. This totally ischemic cul-de-sac of bronchus was wrapped by an omental flap in five of the 10 dogs. All dogs without an omental wrap died of graft necrosis within 5 days. Injection studies into the bronchial arteries failed to demonstrate any revascularization of the bronchial grafts. In contrast, those dogs with omental wraps, when put to death at 23 days, displayed healthy viable bronchial grafts with full revascularization from the omental vessels. In another three dogs the revascularization via the omentum was demonstrated as early as 4 days and well established at 8 days. The ability of the omentum to rapidly revascularize the bronchus may be of value in potentially ischemic bronchial anastomoses such as in lung transplantation.