We report the intraoperative management of an orthotopic cardiac xenotransplant in a 57-year-old man with nonischemic cardiomyopathy requiring venoarterial extracorporeal membrane oxygenation. Transesophageal echocardiography was used for preharvest assessment. Continuous ex vivo perfusion of the heart was performed. Steps were taken to avoid potential xenozoonosis transmission to other patients and staff. Preclinical experience guided our intraoperative management in controlling hemodynamics and using prophylactic antiarrhythmic medications. Echocardiography aided in the diagnosis of aortic dissection in the patient after transplant. Intraoperative cardiac function was excellent. The patient was weaned from all mechanical support 4 days after transplant.
Keyphrases
- extracorporeal membrane oxygenation
- left ventricular
- acute respiratory distress syndrome
- patients undergoing
- end stage renal disease
- aortic dissection
- heart failure
- computed tomography
- pulmonary hypertension
- endothelial cells
- case report
- ejection fraction
- chronic kidney disease
- stem cells
- newly diagnosed
- magnetic resonance
- prognostic factors
- patient reported outcomes
- cardiac resynchronization therapy
- left atrial appendage
- human health
- contrast enhanced
- cell therapy
- mechanical ventilation
- induced pluripotent stem cells