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Ann Thorac Surg 2001;72:1405-1406
© 2001 The Society of Thoracic Surgeons

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Modification of bicaval anastomosis technique for orthotopic heart transplantation

Soichiro Kitamura, MDa, Takeshi Nakatani, MDa, Ko Bando, MDa, Yoshikado Sasako, MDa, Junjiro Kobayashi, MDa, Toshikatsu Yagihara, MDa

a Department of Cardiovascular Surgery, National Cardiovascular Center, Osaka, Japan

Accepted for publication May 16, 2001.

Address reprint requests to Dr Kitamura, Department of Cardiovascular Surgery, National Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka 565-8565, Japan
e-mail: skitamur{at}hsp.ncvc.go.jp

A modified bicaval anastomosis technique was utilized for 4 consecutive patients undergoing heart transplantation. Instead of transecting the superior and inferior vena cavae, a strip of the posterior right atrial wall was left undivided as a bridge connecting the superior and inferior vena cavae. This minor modification perfectly prevented shrinkage and retraction of the caval tissue, thus providing easier anastomotic orientation and better estimation of the appropriate tissue length that fits well, particularly when a small donor heart was available.




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