Korean J Thorac Cardiovasc Surg.
2000 Mar;33(3):207-211.
Application of the New Surgical Technique for Orthotopic Heart Transplantation
in Dogs
- Affiliations
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- 1Department of Thoracic & Cardiovascular Surgery, Mokdong Hospital, Ewha Women's University College of Medicine, Seoul, Korea.
- 2Department of Thoracic & Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Abstract
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BACKGROUND: Conventional cardiac transplantation with each atrial anastomosis designed by
Shumway and associates has been used widely in cardiac transplantation because of its
simplicity and efficiency. There have been many reports about the postoperative
atrioventricular value regurgitation resulting from the alteration in atrial geometry after
cardiac transplantation by Shumway's technique. New surgical technique of direct anastomosis
of superior vena cava, inferior vena cava, right pulmonary vein and left pulmonary vein was
introduced to overcome the those problems. We performed this study to test the feasibility of
this new surgical technique prior to application to clinical practice.
MATERIAL AND METHOD: Conventional cardiac transplantation was performed on 12 mongrel
dogs(Group I) and cardiac transplantation with new surgical mthod of direct anastomosis of
SVC, IVC, left and right pulmonary veins was performed on 11 mongrel dogs(Group II). After
weaning from cardiopulmonary bypass, we compared the postoperative rhythm, hemodynamic data,
and echocardiographic findings between two groups.
RESULT: The cardiopulmonary bypass time and graft ischemic time were 119.0+/-4.4 minutes,
162.0+/-4.5 minutes respectively in group I, and 140.0+/-7.1 minutes, 180.5+/-5.4 minutes
respectively in group II. The cardiopulmonary time and graft ischemic time in group II were
longer than those of group I (p<0.05). There were 3 cases of failure to weaning from
cardipulmonary bypass onein group I and two in group II, and this difference was not
significant statistically. Sinus rhythm was regained postoperatively in 58% (group I) and
82%(group II), without statistical significant between 2 groups. Postoperative
echolcardiography showed 2 cases of tricuspid value regurgitation and 1 case of mitral
regurgitation in group I, and no regurgitation of atrioventricular value in group II.
CONCLUSIONS
Although these was no statistically significant difference between 2 groups,
there was tendency of less arrhythmia and less atrioventricular valvular regurgitation in
group II. We suggested that the new surgical technique could be a useful strategy in heart
transplantation, especially in the case of size mismatching between donor and recipient.