Thoracic and Mediastinal Inspection, Heart Procurement

Abstract

Chest inspection is essential to prevent infective or neoplastic transmission to recipients. Heart-harvesting procedure represents the last and also one of the most defined chances to evaluate the capability of the organ before transplantation. The sternum is opened through a median sternotomy; the anterior pericardium is incised on the midline and then suspended. At this point, it is possible to perform a careful inspection of the donor heart in order to evaluate the heart function. If the donor heart is considered suitable for transplantation, the aorta is clamped and cardioplegic infusion is started. When cardioplegic infusion is completed the heart is excised dividing inferior vena cava, right and left pulmonary veins and arteries, superior vena cava and the aorta just below the crossclamp; in case lungs are being retrieved, an atrial cuff must be tailored along the pulmonary veins.