Surgical Technique of Orthotopic Heart Transplantation. 2: Bicaval ‘Total’ Approach

  • G. Dreyfus


Since 1960, orthotopic heart transplantation (OHT) has been performed according to the technique of Lower and Shumway[1] (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[2] 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[3] had reported modifications to the standard technique by removing both native atria. Finally, in 1991 the ‘total’ orthotopic heart transplant technique was first reported[4].


Pulmonary Vein Left Atrium Donor Heart Orthotopic Heart Transplantation Inferior Pulmonary Vein 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Shumway NE, Lower RR, Stofer RC. Transplantation of the heart. Adv Surg. 1996;2:265.Google Scholar
  2. 2.
    Reitz BA. Heart and lung transplantation, In: Baumgartner WA, Reitz BA, Achull SC, editors, Heart and heart-lung transplantation. Philadelphia, PA. Saunders, 1990:338.Google Scholar
  3. 3.
    Yacoub MH, Banner NA. Recent developments in lung and heart-lung transplantation. Transplant Rev. 1989;3:1.CrossRefGoogle Scholar
  4. 4.
    Dreyfus G, Jebara V, Mihaileanu S, Carpentier A. Total orthotopic heart transplantation: an alternative to the standard technique. Ann Thorac Surg. 1991;52:1181.PubMedCrossRefGoogle Scholar
  5. 5.
    Deleuze PH, Benvenuti C, Mazzucotelli JP et al. Orthotopic cardiac transplantation with direct caval anastomosis: is it the optimal procedure? J Thorac Cardiovasc Surg. 1995;109:731.PubMedCrossRefGoogle Scholar
  6. 6.
    Sievers HH, Leyh R, Jahnke A et al. Bicaval versus atrial anastomosis in cardiac transplantation: right atrial dimension and tricuspid valve function at rest and during exercise up to thirty-six months after transplantation. J Thorac Cardiovasc Surg. 1994;108:780.PubMedGoogle Scholar
  7. 7.
    Sarsam MA, Campbell CS, Yonan NA, Deiraniya AK, Rahman AN. An alternative surgical technique in orthotopic cardiac transplantation. J Card Surg. 1993;8:344.PubMedCrossRefGoogle Scholar
  8. 8.
    Sievers HH, Weyand M, Kraatz EG, Bernhard A. An alternative technique for orthotopic cardiac transplantation with preservation of the normal anatomy of the right atrium. Thorac Cardiovasc Surg. 1991;39:70.PubMedCrossRefGoogle Scholar
  9. 9.
    El Gamel A, Yonan NA, Rahman AN et al. The clinical benefit of the bicaval technique for cardiac transplantation (Letter). J Thorac Cardiovasc Surg. 1995;109:1257.PubMedCrossRefGoogle Scholar
  10. 10.
    Leyh RG, Jahnke AW, Kraatz EG, Sievers H-H. Cardiovascular dynamics and dimensions after bicaval and standard cardiac transplantation. Ann Thorac Surg. 1995;59:1495.PubMedCrossRefGoogle Scholar
  11. 11.
    El Gamel A, Yonan NA, Grant S et al. Orthotopic cardiac transplantation: a comparison of standard and bicaval Wythenshawe techniques. J Thorac Cardiovasc Surg. 1995;109:721.PubMedCrossRefGoogle Scholar
  12. 12.
    Blanche C, Valenza M, Czer LSC et al. Orthotopic heart transplantation with bicaval and pulmonary venous anastomoses. Ann Thorac Surg. 1994;58:1505.PubMedCrossRefGoogle Scholar
  13. 13.
    Angermann CE, Spes CH, Tammew A et al. Anatomic characteristics and valvular function of the transplanted heart: transthoracic versus transoesophageal echocardiographic findings. J Heart Transplant. 1990;9:331.PubMedGoogle Scholar

Copyright information

© Kluwer Academic Publishers 1996

Authors and Affiliations

  • G. Dreyfus

There are no affiliations available

Personalised recommendations