Background: Extension of bronchogenic carcinoma to the proximal main bronchus, carina, and the distal trachea is a classic contraindication to operation. On the other hand, many authors’ experience indicates that tracheal
sleeve pneumonectomy for bronchogenic carcinoma with extension to the carina is now fully justified considering the low operative mortality and good results observed when lateral tracheal lymph nodes were not
involved.
Case report: We used successfully the mammary artery pedicle flap for covering and protection of the tracheo- bronchial anastomosis. To our knowledge, there have been no clinical reports demonstrating the use of the
mammary pedicle flap to bronchial anastomosis covering for revascularization. The procedure described here may be applied in operations for cancer involving the trachea, carina or the main bronchus.
Conclusion: We have demonstrated that the internal mammary pedicle flap technique is a safe and fast procedure and its use in modern thoracic surgery is well founded on the basis of experimental and clinical results.

Keywords: internal mammary artery pedicle flap, Thoracic Surgery, bronchial wrapping, bronchial anastomosis