Related Experiment Video
Updated: Aug 12, 2026
A Preclinical Model of Orthotopic Heart Transplantation in Bama Miniature Pigs Using Biatrial Technique
Published on: June 13, 2025
A lost art-The biatrial technique for adult orthotopic heart transplantation
Aaron M Williams1, Chen Chia Wang2, Kevin C McGann1
1Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tenn.
Objectives:
The biatrial anastomosis technique was the original method of performing orthotopic heart transplantation. More recently, bicaval implant has become the preferred technique of choice. However, situations such as a complex redo sternotomy or size mismatch between donor and recipient vena cava may necessitate the use of the biatrial technique.
Methods:
This article highlights our institutional biatrial implant technique to ensure modern heart transplant surgeons retain proficiency in this method of heart transplantation.
Results:
Although the pacemaker rates in the biatrial cohort were greater than that in our bicaval cohort, the rates of tricuspid regurgitation and right ventricular dysfunction were similar.
Conclusions:
Our manuscript highlights the timing of a biatrial heart transplant and details the operative steps necessary to avoid significant atrial or valvular distortion.
