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Complete atrioventricular cardiac transplantation: improved performance compared with the standard technique
H B Bittner1, S W Kendall, E P Chen
1Department of General and Cardiothoracic Surgery, Duke University Medical Center, Durham, NC 27710, USA.
The Annals of Thoracic Surgery
|August 1, 1995
Summary
The complete atrioventricular transplantation technique preserves normal sinus rhythm and biventricular filling. This surgical approach is a viable alternative to standard cardiac transplantation methods.
Area of Science:
- Cardiovascular Surgery
- Transplantation Medicine
- Surgical Innovation
Background:
- Renewed clinical interest in alternative cardiac transplantation techniques.
- Comparison of a six-anastomosis complete technique versus standard ventricular transplantation with atrioplasty.
Purpose of the Study:
- To compare the outcomes of complete atrioventricular transplantation with standard cardiac transplantation.
- To evaluate the feasibility and efficacy of the complete technique.
Main Methods:
- Acute standard and complete atrioventricular transplantations were performed in dogs.
- Baseline cardiac function, bypass, and ischemic times were assessed.
- Post-transplantation hemodynamics and cardiac function were evaluated.
Main Results:
- Sinus rhythm was preserved in all complete technique cases versus one standard case.
- Right ventricular function significantly decreased in the standard group post-transplantation.
- Biventricular filling rates were significantly reduced in the standard group.
Conclusions:
- Complete atrioventricular transplantation is a feasible alternative preserving sinus rhythm.
- Ischemic and bypass times are comparable between the two techniques.
- The complete technique may conserve biventricular diastolic function post-transplantation.