Application of modified bicaval technique for pediatric heart transplant with oversized donor heart

  • Takaya HoashiEmail author
  • Heima Sakaguchi
  • Masatoshi Shimada
  • Kenta Imai
  • Motoki Komori
  • Hajime Ichikawa
Case Report


Whereas bicaval technique is an effective surgical method, standard bicaval technique for younger age and donor/recipient caval mismatch was reported to have a risk of superior vena caval obstruction. Between 2016 and 2019, three patients with dilated cardiomyopathy aged 10 years or younger underwent orthotropic heart transplantation with modified bicaval technique at our institute. Donor/recipient body weight and height ratios were 2.36, 0.77, and 2.61 and 1.37, 0.94, and 1.51, respectively. All patients were preoperatively supported by a left ventricular assist device: Excor Pediatric in two patients and Jarvik 2000 in one. Duration of LVAD support was 180, 238, and 220 days. One patient required revision of pulmonary anastomosis during the operation; accordingly, the chest was closed 3 days later. There was no mortality. Caval obstructions were not observed. Three months after the operation, tricuspid regurgitation was mild in two patients and trivial in one.


Pediatric heart transplantation Modified bicaval technique 



The author(s) received no financial support for the research, authorship, and/or publication of this article.

Compliance with ethical standards

Conflict of interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.


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Copyright information

© The Japanese Association for Thoracic Surgery 2019

Authors and Affiliations

  1. 1.Department of Pediatric Cardiovascular SurgeryNational Cerebral and Cardiovascular CenterSuitaJapan
  2. 2.Department of Pediatric CardiologyNational Cerebral and Cardiovascular CenterSuitaJapan

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