Selective bronchial arteriography and bronchial blood flow; correlative study

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

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.

Swyer-James (Macleod's) syndrome. Variations in pulmonary-bronchial arterial blood flow

The Swyer-James (Macleod's) syndrome (or unilateral hyperlucency of the lung) frequently presents a diagnostic problem. Two cases of this entity are reported that demonstrate its similarity to and differentiation from pulmonary embolism and other intrapulmonic disorders. Detailed roentgenologic and physiologic studies were performed to define the diagnostic criteria of this syndrome. The reciprocal relationship of the bronchial arterial circulation in the hyperlucent lung was described.