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Published ahead of print on October 20, 2005, doi:10.1164/rccm.200506-894OC

Am. J. Respir. Crit. Care Med., Volume 173, Number 3, February 2006, 345-349

A more recent version of this article appeared on February 1, 2006
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Submitted on June 9, 2005
Accepted on October 18, 2005

Regression of the Systemic Vasculature to the Lung After Removal of Pulmonary Artery Obstruction

Elie Fadel1*, Edo Wijtenburg1, Rene Michel2, Jean-Xavier Mazoit3, Renee Bernatchez2, Benoit Decante1, Edouard Sage1, Michel Mazmanian1, and Philippe Herve1

1 Laboratoire de Chirurgie Experimentale UPRES-EA 2705, Paris South University, Hopital Marie Lannelongue, Le Plessis-Robinson, France, 2 Department of Pathology, McGill University, Montreal, QC, Canada, 3 Laboratoire d'Anesthesie, Paris South University, Le Kremlin-Bicetre, France

* To whom correspondence should be addressed. E-mail: efadel{at}free.fr.

Rationale: Pulmonary artery occlusion stimulates angiogenesis in the systemic circulation of the ipsilateral lung and increases systemic-to-pulmonary blood flow. Whether this systemic neovascularization decreases after lung revascularization is unknown. Objectives: To assess the influence of lung revascularization on anatomy and flow of bronchial vessels supplying a chronically ischemic lung in piglets. Methods: Piglets were studied before (control) and 5 weeks after left pulmonary artery ligation then 5 weeks after left pulmonary artery reimplantation into the pulmonary artery trunk. The systemic blood flow to the right and left lungs was measured using colored microspheres, and the bronchial vasculature was assessed using light-microscopic morphometry. Renal and total blood flow, systemic blood pressure, and pulmonary blood pressure were measured in each experimental condition. Measurements and Main Results: Systemic blood flow to the left lung increased from 0.4±0.1 to 11.5±3.8 ml/min/g (p<0.05) after left pulmonary artery ligation and returned toward the control value (1.2±0.6 ml/min/g) after revascularization, whereas it remained unchanged in the right lung. The number of bronchial vessels increased 2- fold in the ligated lung (p=0.01), and did not decrease after reperfusion; however, vessel diameters decreased markedly. Renal and total blood flows, as well as mean pulmonary and systemic arterial pressures, were similar in the three experimental conditions. Conclusion: Revascularization after a period of left pulmonary artery occlusion normalizes the systemic blood flow to the left lung and induces partial loss of collateral vessels.


Key words: Bronchial Arteries, Pulmonary artery, Pulmonary thromboembolism, Pig




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