Modified operation technique for orthotopic heart transplantation

Détails

ID Serval
serval:BIB_0EC183060D78
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Modified operation technique for orthotopic heart transplantation
Périodique
European Journal of Cardio-Thoracic Surgery
Auteur(s)
Laske  A., Carrel  T., Niederhauser  U., Pasic  M., von Segesser  L. K., Jenni  R., Turina  M. I.
ISSN
1010-7940
Statut éditorial
Publié
Date de publication
1995
Peer-reviewed
Oui
Volume
9
Numéro
3
Pages
120-6
Notes
Comparative Study
Journal Article
Résumé
Atrioventricular (AV) valve dysfunction with tricuspid regurgitation is a common finding after orthotopic heart transplantation (HTx). In 20 patients the heart transplantation was performed with bicaval anastomoses and the results were compared to the precedent 20 patients operated with the standard technique. The right atrium of the recipient was completely removed and the caval anastomoses were performed on the beating heart during reperfusion. Using an interrupted suture line, no stenoses at the venous anastomoses were seen as known from the early implantation technique in heart-lung transplantation. Due to a more stable sinus rhythm only 15% of the patients in the bicaval group needed prolonged pacing (> 30 min) versus 55% (P < 0.01) in the group with standard operation. One to 3 months after surgery the transthoracic echocardiographic evaluation of the AV valve function showed tricuspid valve regurgitation (TVR) in 20% of the patients with bicaval anastomoses versus 75% with a right atrial anastomosis (P < 0.001). Tricuspid valve regurgitation during the first 2 weeks (in 31% of recipients with bicaval and in 70% with atrial anastomoses) improved in all recipients with bicaval anastomoses and in 14% of the recipients with atrial anastomosis. The modification of the operation technique did not result in significantly longer bypass time (75 +/- 14 versus 68 +/- 14 min) and ischemia time (44 +/- 12 versus 41 +/- 9 min with local organ procurement and 111 +/- 24 versus 101 +/- 19 min with distant organ procurement). The AV valve function and the postoperative rhythm after orthotopic HTx can be improved by implanting the heart with bicaval anastomoses.
Mots-clé
Adult Anastomosis, Surgical/*methods Cardiac Pacing, Artificial Echocardiography Electrocardiography, Ambulatory Female Follow-Up Studies Heart Atria/surgery Heart Transplantation/*methods Hemodynamics/physiology Humans Male Middle Aged Postoperative Complications/prevention & control/*ultrasonography Suture Techniques Tricuspid Valve Insufficiency/prevention & control/*ultrasonography Vena Cava, Superior/surgery
Pubmed
Web of science
Création de la notice
14/02/2008 14:19
Dernière modification de la notice
20/08/2019 12:35
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