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Novel technique for isolated accessory right heart transplantation for congenital heart disease  John Elefteriades, MD, Costantinos Lovoulos, MD, Randolph.

Published byErica Oswalda Maier Modified over 5 years ago

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Presentation on theme: "Novel technique for isolated accessory right heart transplantation for congenital heart disease  John Elefteriades, MD, Costantinos Lovoulos, MD, Randolph."— Presentation transcript:

1 Novel technique for isolated accessory right heart transplantation for congenital heart disease 
John Elefteriades, MD, Costantinos Lovoulos, MD, Randolph Edwards, MD, Shawn Tittle, MD, Timothy Riley, MD, Paul Tang, MD, Edward Rocco, CCP, Gary Kopf, MD  The Journal of Thoracic and Cardiovascular Surgery  Volume 125, Issue 6, Pages (June 2003) DOI: /S (02)

2 Figure 1 Schematic view of the isolated right heart remaining after excision of the LV. Note preservation of the LAD. The PDA is also preserved (not shown). Note ligation of the coronary sinus. Also shown are the long stumps preserved to facilitate later anastomoses: right PA, innominate and right subclavian veins, and entire aortic arch. Note the hemostatatic over-and-over suture on the free edge of the former LV. Note that the aortic valve is exposed on its inflow side to the pericardial space. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (02) )

3 Figure 2 PA anastomosis done in the fissure between lobes and performed in an end-to-side fashion. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (02) )

4 Figure 3 SVC anastomosis performed in an end-to-side fashion. Note that the azygos vein of the donor has previously been ligated. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (02) )

5 Figure 4 Arterial inflow anastomosis. The anastomosis is shown here constructed between the left subclavian artery of the donor (borrowed for use) and the left carotid branch of the donor aortic arch. This anastomosis is performed in an end-to-side fashion. The sole purpose is to provide inflow to the coronary arteries of the donor right heart; any combination of aortic arch branches can be used. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (02) )

6 Figure 5 The completed operation. Note that the accessory right heart hugs the right border of the native heart but lies in the right pleural space. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (02) )

7 Figure 6 Schematic diagrams of resultant circulation. Note that the accessory right heart is connected in parallel with the native right heart. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (02) )

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