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
- heart failure
- aortic dissection
- case report
- endothelial cells
- computed tomography
- newly diagnosed
- ejection fraction
- pulmonary hypertension
- respiratory failure
- stem cells
- magnetic resonance
- mesenchymal stem cells
- risk assessment
- climate change
- patient reported outcomes
- induced pluripotent stem cells