PA sleeve resection was first reported in 1967 by Gundersen [2], and thus far the use of various materials to perform PA reconstruction with patch repair or conduit interposition has been reported. Conduit interposition is the best choice for cases in which there is an extensive PA defect. Artificial materials, such as polytetrafluoroethylene, carry a high risk of thrombosis and require long-term anticoagulation. Rendina et al. [3] described the use of an autologous pericardial conduit, which is widely used. Autologous pericardium is available on both sides of the chest and can provide sufficient tissue for repair of a large defect. However, its tendency to shrink and curl makes adaptation and suturing to the vascular wall more difficult. Cerezo et al. [4] reported the first use of an autologous PV conduit in 2009, and in a report of one case of autologous PV conduit and seven cases of patch repair, Puma et al. [5] described successful PA reconstruction with an autologous PV conduit that could be performed safely and without recurrence.
In our case, there was extensive invasion of hilar lymph nodes into the PA, but sleeve bronchial resection was not necessary. Fortunately, the tumor was located in the left chest and did not involve the superior PV intrapericardially. We could have chosen a pericardial conduit, but in this case, the autologous PV conduit was naturally tubular and of sufficient length to repair the PA defect. The length of the resected PV has been reported to be from 15 to 30 mm [3, 5, 6], but a sufficiently long PV is not always possible. The most suitable material should be determined for each case. The use of autologous PV is also an oncological problem because of the persistence of microscopic of cancer cells, and long-term results are not clear. In 2014, D’Andrilli et al. [6] reported medium-term results of nine cases of PA reconstruction with an autologous PV conduit. Tumor recurrence was observed in two patients (one local, one systemic) but no evidence of recurrence was found at the site of vascular reconstruction. They demonstrated this technique to be a feasible and effective option with acceptable medium-term results. In the present case, although distant metastases did develop, no recurrence was found at the anastomotic site.