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Surgical Techniques of Heart Transplantation and Heart–Lung Transplantation

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Anesthesia and Perioperative Care for Organ Transplantation

Abstract

Although the number of heart transplantations in the U.S. has plateaued in recent years, its evolution from a pioneering procedure to the treatment of choice for end-stage heart disease has been nothing short of miraculous. The same has been true for the journey of heart–lung transplantation. The risk and challenge of these operations have increased due to changes in patient acuity and profile. Nonetheless, outcomes continue to improve.

The present chapter elucidates the full repertoire of operations for both heart and heart–lung transplantations, including both the donor and recipient procedures. Sections are dedicated to the range of scenarios encountered during harvesting, including the isolated heart harvest, the combined heart and lung harvest for distinct recipients, and the en-bloc heart–lung harvest for a single recipient. Similarly, sections are dedicated to the unique scenarios encountered during implantation, including primary surgery, reoperative surgery, and surgery in patients bridged with mechanical circulatory support. Safeguards and pitfalls are emphasized for each of these scenarios.

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Abbreviations

CPB:

Cardiopulmonary bypass

IVC:

Inferior vena cava

LA:

Left atrium

LSPV:

Left superior pulmonary vein

LVAD:

Left ventricular assist device

MCS:

Mechanical circulatory support

PA:

Pulmonary artery

RA:

Right atrium

RSPV:

Right superior pulmonary vein

SVC:

Superior vena cava

TEE:

Transesophageal echocardiogram

UW:

University of Wisconsin

VAD:

Ventricular assist device

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Author information

Authors and Affiliations

  1. Center for Advanced Heart Failure, McAllen Heart Hospital, 500 E Ridge Road, Suite 200, McAllen, TX, 78503, USA

    Arie Blitz M.D., M.B.A.

Authors
  1. Arie Blitz M.D., M.B.A.
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Corresponding author

Correspondence to Arie Blitz M.D., M.B.A. .

Editor information

Editors and Affiliations

  1. Department of Anesthesiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA

    Kathirvel Subramaniam

  2. Department of Anesthesiology The Clinical and Translational Science Institute The McGowan Institute for Regenerative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA

    Tetsuro Sakai

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Blitz, A. (2017). Surgical Techniques of Heart Transplantation and Heart–Lung Transplantation. In: Subramaniam, K., Sakai, T. (eds) Anesthesia and Perioperative Care for Organ Transplantation. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-6377-5_12

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  • DOI: https://doi.org/10.1007/978-1-4939-6377-5_12

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-6375-1

  • Online ISBN: 978-1-4939-6377-5

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