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Thorac Cardiovasc Surg 2018; 66(05): 410-416
DOI: 10.1055/s-0036-1584908
Original Cardiovascular
Georg Thieme Verlag KG Stuttgart · New York

Over Ten Years of Experience with a Modified Right Atrial Anastomosis in Orthotopic Heart Transplantation: Follow-up and Comparison with the Biatrial and Bicaval Technique

Katharina Huenges
1   Department of Cardiovascular Surgery, University of Schleswig-Holstein Campus Kiel, Kiel, Germany
,
Bernd Panholzer
1   Department of Cardiovascular Surgery, University of Schleswig-Holstein Campus Kiel, Kiel, Germany
,
Katharina Fritzsche
1   Department of Cardiovascular Surgery, University of Schleswig-Holstein Campus Kiel, Kiel, Germany
,
Ole Broch
2   Department of Anesthesiology and Intensive Care Medicine, University of Schleswig-Holstein Campus Kiel, Kiel, Germany
,
Jochen Renner
2   Department of Anesthesiology and Intensive Care Medicine, University of Schleswig-Holstein Campus Kiel, Kiel, Germany
,
Christine Friedrich
1   Department of Cardiovascular Surgery, University of Schleswig-Holstein Campus Kiel, Kiel, Germany
,
Azizolah Rahimi-Barfeh
1   Department of Cardiovascular Surgery, University of Schleswig-Holstein Campus Kiel, Kiel, Germany
,
Alexander Reinecke
1   Department of Cardiovascular Surgery, University of Schleswig-Holstein Campus Kiel, Kiel, Germany
,
Jochen Cremer
1   Department of Cardiovascular Surgery, University of Schleswig-Holstein Campus Kiel, Kiel, Germany
,
Assad Haneya
1   Department of Cardiovascular Surgery, University of Schleswig-Holstein Campus Kiel, Kiel, Germany
› Author Affiliations
Further Information

Publication History

08 April 2016

23 May 2016

Publication Date:
05 July 2016 (online)

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Abstract

Background In 1997, a modified right atrial anastomosis (cavoatrial technique) for orthotopic heart transplantation (oHTx) was first developed in our institution. The purpose of this study is to report our long-term experience with this technique compared with biatrial and bicaval technique.

Methods Retrospectively, 202 consecutive oHTx between 1997 and 2013 were analyzed. The applied transplantation techniques were biatrial (n = 108), bicaval (n = 22), and cavoatrial (n = 72).

Results Demographic data were similar in all groups. The cardiopulmonary bypass and cross-clamp time were significantly shorter in the biatrial group. Follow-up echocardiographic examination showed excellent results in all groups with no relevant differences. After 1 year, occurrence of severe tricuspid regurgitation (biatrial 1.9% vs bicaval 0.0% vs cavoatrial 1.4%) was low in all groups. Rate of permanent pacemaker implantations was also low (12.0% vs 5.0% vs 11.1%). There were no significant differences in survival between the groups.

Conclusion The cavoatrial technique can be a safe and simple alternative for heart transplantation. Easy handling and similar reduced postoperative complications encourage the use of this technique.

Keywords

heart failure - transplantation heart - cardiac

Note

Parts of this manuscript were presented (Scientific poster) at the Annual Meeting of the German Transplantation Society (DTG) in Dresden, Germany on October 22, 2015.


 

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