PEDIATRIC HEART TRANSPLANTATION

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Presentation transcript:

PEDIATRIC HEART TRANSPLANTATION Authors: Roman Flavia-Cristina, Sîrbu Eliza-Dumitrița, Gherman Ioana-Vasilica Sima Diana Carmen Coordinators: Assoc. Prof. Horațiu Suciu, MD.PhD Valentin Stroe, MD.PhD student

Definition Heart Transplantation = a surgical procedure performed on patients with end-stage heart failure; = a major medical procedure.

History The first pediatric heart transplant in the world was performed by Adrian Kantrowitz on December 6, 1967 in Brooklyn, New York.

?Did you know? In 1984, in California, Leonard Bailey, MD, implanted a baboon heart into a 12-day-old girl; “Baby Fae”.

Dr. Leonard L. Bailey with Baby Fae

Indications for Heart Transplantation in Pediatric Heart Disease Pediatric Cardiomyopathies: Dilated (Idiopathic) Hypertrophic Restrictive CHD: Single-Ventricle with Hypoplastic Left Heart Syndrome; Single-Ventricle with Pulmonary Atresia; TGA; RV outflow tract lesions; LV outflow tract lesions; Complete AV canal; Malignant arrhythmias.

4 Cases of Pediatric Heart Transplant in Romania Female, 10 years old, DCMP; Female, 17 years old, DCMP; Female, 15 years old, DCMP; Female, 3.5 years old, DCMP.

Classical Surgical Approach Orthotopic Heart Transplantation with Bicaval Anastomosis(with the primary anastomosis of the Left Atrium) (original Lower-Shumway technique)

Orthotopic Heart Transplantation with Bicaval Anastomosis Original Technique Orthotopic Heart Transplantation with Bicaval Anastomosis (with the primary anastomosis of the Aorta) NEW !!!

Alternative techniques Orthotopic Heart Transplantation – the Lower-Shumway technique; Heterotopic Transplantation =“piggyback” transplantation. VS. Orthotopic Heart Transplantation with Bicaval Anastomosis (with the primary anastomosis of the Aorta) -improved Graft Ischemic Time up to 25-40min

Conclusions Currently Orthotopic Heart Transplantation with Bicaval Anastomosis-with the primary anastomosis of the Aorta is becoming the procedure of choice at our institution; The efficiency of this new technique is proved especially when there is distance from harvest to our city; Heart Transplantation is the only corrective treatment for irreductible end-stage heart failure.

“Two things are bad for the heart-running up stairs and running down people. ” Bernard Baruch