Lung Harvest in Patient with Abnormal Pulmonary vein Drainage

Lung harvest in a patient with abnormal pulmonary vein structure, such as anomalous pulmonary venous return or partial anomalous pulmonary venous connection (PAPVC), demands meticulous preoperative planning and intraoperative precision. Anomalous veins may drain into the right atrium or systemic veins rather than the left atrium, complicating standard dissection and anastomotic strategies. During procurement, it is critical to identify the exact venous anatomy using imaging studies and intraoperative inspection to ensure adequate preservation of the anomalous venous channels. Care must be taken to avoid injury to these atypical veins and to preserve their length for potential reconstruction during transplantation. Coordination with the transplant team is essential to ensure feasibility of recipient adaptation, especially when rerouting of venous drainage is anticipated.