Surgical Technique of Orthotopic Heart Transplantation. 2: Bicaval ‘Total’ Approach
Since 1960, orthotopic heart transplantation (OHT) has been performed according to the technique of Lower and Shumway (Chapter 24). Barnard introduced a small but useful modification whereby the sinoatrial node could be more readily avoided by opening the right atrium from the inferior vena cava to the right atrial appendage (Chapter 24). In 1990, Reitz introduced the domino procedure by using the native heart of a patient undergoing heart-lung transplantation. This was the first approach to bicaval anastomosis with end-to-end anastomoses of both superior (SVC) and inferior (IVC) venae cavae. In 1989 Yacoub and Banner had reported modifications to the standard technique by removing both native atria. Finally, in 1991 the ‘total’ orthotopic heart transplant technique was first reported.
KeywordsPulmonary Vein Left Atrium Donor Heart Orthotopic Heart Transplantation Inferior Pulmonary Vein
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