Human bronchial artery blood flow after lung Tx with direct bronchial artery revascularization

Abstract

The inaccuracy of measuring human bronchial artery blood flow has previously been considerable. En bloc double-lung transplantation with bronchial artery revascularization (BAR) using a single conduit offers the unique opportunity of direct measurement of the total bronchial artery blood flow. In eight en bloc double-lung-transplanted patients with complete BAR, the basal blood flow was measured by using a 0.014-in. Doppler guide wire and arteriography. The average peak velocity in the conduit was 12–73 cm/s [±2.1 (SD) cm/s], and the conduit diameter was 1.7–3.1 mm [±0.10 (SD) mm], giving individual basal flow values between 19 and 67 ml/min [±5 (SD) ml/min], or 0.2–1.9% of estimated cardiac output. In three patients basal measurements were followed by injection of nitroglycerin and verapamil into the conduit. This increased the bronchial artery flow to 121–262% of basal values (31–89 ml/min). The measured values appear more physiologically plausible than previous bronchial artery blood flow measurements in humans.