Related Experiment Video
Updated: Aug 16, 2026
Blood Circuit Reconstruction in an Abdominal Mouse Heart Transplantation Model
Published on: June 3, 2021
Bicaval anastomosis reduces tricuspid regurgitation after heart transplantation
Kook-Yang Park1, Chul-Hyun Park, Yang-Bin Chun
1Gil Heart Center, 1198 Kuwol-dong, Namdong-ku, Inchon 405-760, South Korea. kkyypark@ghil.com
Insights
The bicaval anastomosis technique for heart transplantation shows a lower prevalence of tricuspid regurgitation compared to the standard technique. This suggests the bicaval method may improve long-term outcomes for heart transplant recipients.
Area of Science:
- Cardiology
- Surgical Innovation
Background:
- The standard two-atrial cuff anastomosis has been the predominant heart transplantation technique.
- Bicaval anastomosis has emerged as a newer surgical approach.
Purpose of the Study:
- To compare the incidence of tricuspid regurgitation between bicaval and standard anastomosis techniques in heart transplantation.
Main Methods:
- Retrospective analysis of 43 heart transplantations performed between April 1994 and December 2003.
- Patients were divided into two groups: standard technique (n=15) and bicaval technique (n=28).
- Comparison of tricuspid regurgitation prevalence and survival rates.
Main Results:
- The prevalence of moderate or greater tricuspid regurgitation was significantly higher in the standard technique group (36.4%) compared to the bicaval group (10.5%; p < 0.05).
- One-year survival rates were similar (87% vs. 86%).
- Three-year survival rates showed a trend favoring the bicaval technique (55% vs. 78%), with a significant difference in 3-year mortality.
Conclusions:
- The bicaval anastomosis technique is associated with a reduced incidence of tricuspid regurgitation post-heart transplantation.
- The bicaval technique may offer improved long-term survival outcomes.
- This technique should be considered the preferred method for heart transplantation.
Abstract:
The standard surgical technique utilizing two atrial cuff anastomoses has been used in the majority of transplant centers until recently when bicaval anastomoses was introduced. The purpose of this study was to compare the prevalence of tricuspid regurgitation after the bicaval and standard techniques of anastomosis. Heart transplantation was performed in 43 patients at our institution from April 1994 to December 2003: 15 by the standard technique (group A) and 28 by the bicaval technique (group B). No differences in pre-transplant diagnosis, donor age, immunosuppression, rejection treatment, or graft ischemic time were evident between the two groups. The prevalence of tricuspid regurgitation (> or = moderate) was higher after the standard technique (36.4% vs. 10.5%; p < 0.05). Survival rates at 1 and 3 years in group A were 87% and 55%, and 86% and 78% in group B, with a significant difference in the 3-year mortality. The bicaval anastomosis technique was found to be associated with a lower incidence of tricuspid regurgitation during the late postoperative period, and should be preferred for heart transplantation.
