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Major Complications of Heart Transplant Surgery

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The High-risk Surgical Patient

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Abstract

Orthotopic heart transplantation technique, since its introduction by Lower and Shumway in 1960, has been the same except for the introduction of separate caval anastomoses for the right atrium suture. Due to the relative easiness, complications directly related to the surgical technique are uncommon. In this chapter, we discuss the main complications of heart transplant surgery, trying at the same time to underline pitfalls and tips. The major complications of heart transplant surgery may be summarized as follows: (a) primary graft failure; (b) valvular incompetence for atrial wall distortion; (c) cardiac tamponade; (d) creation of a pseudo-cor-triatriatum; (e) distortion of the pulmonary trunk; (f) sinoatrial block and arrhythmias; (g) atrial thrombosis at the suture line; (h) aorta anastomosis complications; (i) mediastinitis; and (j) donor/recipient mismatch in size.

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Authors and Affiliations

  1. Department of Cardiac Surgery, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy

    Antonino Massimiliano Grande M.D.

  2. Department of Cardiac Surgery, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France

    Antonio Fiore M.D.

  3. Sapienza University of Rome, Roma, Italy

    Antonio Fiore M.D.

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  1. Antonino Massimiliano Grande M.D.
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  2. Antonio Fiore M.D.
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Correspondence to Antonino Massimiliano Grande M.D. .

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Editors and Affiliations

  1. Dipartimento di Emergenza Urgenza, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy

    Paolo Aseni

  2. Divisione di Cardiochirurgia, IRCCS Fondazione Policlinico San Matteo, Pavia, Pavia, Italy

    Antonino Massimiliano Grande

  3. Div. of Emerg. Surg., Abdominal Center, Helsinki University Hospital Meilahti, Helsinki, Finland

    Ari Leppäniemi

  4. Department of Pathophysiology and Transplantation, General Surgery and Trauma Team, University of Milano, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy

    Osvaldo Chiara

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Grande, A.M., Fiore, A. (2023). Major Complications of Heart Transplant Surgery. In: Aseni, P., Grande, A.M., Leppäniemi, A., Chiara, O. (eds) The High-risk Surgical Patient. Springer, Cham. https://doi.org/10.1007/978-3-031-17273-1_53

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