Heterotopic Heart Transplantation as a Left Ventricular Biological Assistance: a New Two-Stage Method Proposal.
Fabio Antonio GaiottoAntonio Carlos de Almeida BarbosaDavi Freitas TenórioSamuel Padovani SteffenFabio B JatenePublished in: Brazilian journal of cardiovascular surgery (2020)
Since Barnard's first heterotopic heart transplant in 1974, Copeland's method has been the greatest contribution to heterotopic transplants but has the drawback of donor's right ventricular atrophy. This new method proposes a modification in the anastomosis of the superior vena cava aiming to pre-serve donor's right ventricular function by decompressing the pulmonary territory and reducing the pulmonary arterial pressure, as a biological ventricular assist device. Finally, a second intervention is proposed, where a "twist" is performed to place the donor's heart in an orthotopic position after re-moval of the native heart. A pioneering research on this method received approval from the ethics committee of the Heart Institute of São Paulo. We believe that this method has the potential to im-prove quality of life in a selected group of patients.
Keyphrases
- heart failure
- left ventricular
- vena cava
- pulmonary hypertension
- randomized controlled trial
- atrial fibrillation
- end stage renal disease
- ejection fraction
- public health
- chronic kidney disease
- epithelial mesenchymal transition
- mitral valve
- coronary artery disease
- acute myocardial infarction
- machine learning
- inferior vena cava
- prognostic factors
- acute coronary syndrome
- climate change
- deep learning
- aortic valve
- patient reported