Method of Pulmonary Arterial Pressure Correction During Pulmonectomy by Forming Intervascular Anastomoses (Experimental Study)

The aim of the study was to assess the possibility of reducing pulmonary arterial pressure by creating various types of intervascular anastomoses during left-sided pulmonectomy in the experiment.

Materials and Methods. The experimental study was carried out on 102 laboratory animals (mini pigs) aged 24–27 months weighing 12–17 kg. Three series of experiments have been performed. In the first series (n=34), left-sided pulmonectomies which corresponded to the removal of 42 weight percent of pulmonary tissue were done. In the second series (n=34), arteriovenous shunting of the pulmonary circulation by end-to-end connection of the proximal sections of the inferior lobar artery and the like-named vein on the operated side was carried out during left-sided pulmonectomies. In the third series (n=34), arterio-arterial shunting by connecting the proximal section of the superior lobar artery on the operated side with the distal section of the subclavian artery on the same side was performed during left-sided pulmonectomies.

Results. Lethality of the animals after pulmonectomy performed by a conventional method without anastomoses (series 1) was 1:3 (10 of 34 operated pigs died), and 8 of 10 died of acute edema.

Among the animals undergone pulmonectomy with arteriovenous shunt functioning between the pulmonary artery and the vein on the operated side (series 2), lethality appeared to be smaller, about 1:6 (6 of 34 mini pigs died). None of the animals suffered death from acute pulmonary edema.

Lethality among the animals of series 3, in which the pulmonary artery on the side of the removed lung was connected with the distal section of the subclavian artery, was the highest making half of the total number of the operated animals. 14 mini pigs died from acute pulmonary edema within the first hours after the operation, 4 died 4 months later from right ventricular failure.

Conclusion. Pulmonectomy with the shunt functioning between the inferior lobar artery and vein on the operated side provides the possibility to avoid acute edema of the remaining lung during the operation and soon after it.

1. Almabaev Y.A., Almabaeva A.Y., Musaev A.T., Serikpaev Z.Z., Lesbekova R.B., Nurmukhanbetova D.K., Makhatov B.M., Uglanov Z.S., Zholdybaev S.S., Ismaylov D.I., Bukharbekov B.B., Aldabergenov E.N., Kolbekova A.A., Ermakhanova A.B. Description of hemodynamic changes in catamnesis after pneumonectomy. Sovremennye problemy nauki i obrazovania 2016; 1: 35.
2. Daminov R.U. The state of internal organ circulation in the postoperative period after experimental left pulmonectomy. Molodoy uchenyy 2017; 18: 117–119.
3. Voytsekhovskiy V.V., Landyshev Yu.S., Grigorenko A.A. Morphofunctional state of the bronchial system in patients with multiple myeloma. Pul’monologia 2010; 4: 49–53.
4. Lahera V., Goicoechea M., de Vinuesa S.G., Oubiña P., Cachofeiro V., Gómez-Campderá F., Amann R., Luño J. Oxidative stress in uremia: the role of anemia correction. J Am Soc Nephrol 2006; 17(12 Suppl 3): S174–S177, https://doi.org/10.1681/asn.2006080911.
5. Belevitin A.B., Tarasov V.A., Naumov A.V., Povarenkov A.S., Biryukov A.V., Romanovsky D Yu., Larin I.A., Kruchinenko A.Yu., Khubulava G.G. Operative isolated chemohyperthermal perfusion of the lung with ablation of pulmonary metastases. Vestnik hirurgii imeni I.I. Grekova 2010; 169(4): 12–16.
6. Iakovlev A.Iu., Gordeeva O.S., Denisenko A.N., Vorontsov A.Iu., Ulitin D.N. Postoperative correction of the methabolism of the single lung after pulmonectomy. Khirurgiya. Zhurnal imeni N.I. Pirogova 2011; 4: 47–50.
7. Moroz V.V. Strategiya i taktika primeneniya antigipoksantov pri kriticheskikh sostoyaniyakh. V kn.: Fundamental’nye problemy reanimatologii (izbrannye lektsii i obzory). Trudy Instituta obshchey reanimatologii RAMN. T. IV [Strategy and tactics of using antihypoxic agents in critical conditions. In: Fundamental problems of emergency medicine (selective lectures and reviews). Proceedings of Research Institute of General Reanimatology of RAMS. Vol. IV]. Moscow; 2005; p. 210–220.
8. Sabirov Sh.Yu., Nematov O.N., Mayusupov Sh.E., Riskiev A.A., Rakhmanov Sh.A., Nasritdinov B.I., Ermakov E.F., Abdumadzhitov A.M. New approaches to the vast lung resections and pulmonectomy in disseminated and drug-resistant tuberculosis. Molodoy uchenyy 2017; 5.2: 49–51.
9. Shatokhin K.S., Kniazev S.P., Ermolaev V.I., Goncharenko G.M., Deeva V.S., Zaporozhets V.I., Orlova K.S., Nikitin S.V. Biodiversity of ICG mini-pigs as laboratory bioresources. Vestnik NGAU (Novosibirskii gosudarstvennyi agrarnyi universitet) 2016; 4(41): 67–74.
10. Vachnadze D.I., Breshenkov D.G., Dydykin S.S. Anesthesia in swines as a model in biomedical and biotechnological studies. Voprosy rekonstruktivnoy i plasticheskoy khirurgii 2016; 4(59): 37–56.
11. Govorin A.V. Nekoronarogennye porazheniya miokarda [Non-coronarogenic myocardial injury]. Novosibirsk: Nauka; 2014.
12. Sokolova N.A., Chartorizhskaya N.N., Govorin A.V. Clinical and pathologic features of cardiac complications in patients with acute poisoning acetic acid. Serdtse: zhurnal dlya praktikuyushchikh vrachey 2011; 4(60): 245–246.
13. Almabayeva A.Y., Begalin T.B., Nazhimov B.S. Method of withdrawing animals from the experiment. Patent 11756 RK. 2002.
14. Korzhevsky D.E., Gilyarov A.B. Osnovy gistologicheskoy tekhniki [Fundamentals of histological technique]. Saint Petersburg: SpetsLit; 2010.

Nadyrov М.Т., Almabayev Y.А., Baimahanov А.N., Fakhradiyev I.R., Almabayeva А.Y., Tanabayev B.D., Kulimbet М.B., Raimhanov А.D. Method of Pulmonary Arterial Pressure Correction During Pulmonectomy by Forming Intervascular Anastomoses (Experimental Study). Sovremennye tehnologii v medicine 2019; 11(3): 41, https://doi.org/10.17691/stm2019.11.3.05