Everting mattress running suture: an improved technique of atrial anastomosis in human lung transplantation

Significant complications related to the venous anastomosis have been reported in clinical lung transplantation, and it has been suggested that the incidence of pulmonary vein complications may have been previously underestimated. In our institution, we have adopted the horizontal everting mattress running suture as standard practice for the venous anastomosis in human lung transplantation. This technique is easier to perform than the regular over-and-over sutures, and allows suturing of the donor and recipient atrial cuffs in a straight line, opposing endothelium to endothelium, thus limiting the presence of redundant and potentially thrombogenic tissue in the lumen. This technique should help reduce the risk of venous anastomotic complications.