Heterotopic versus orthotopic heart transplantation
Barnard, C.N.; Wolpowitz, A.
Transplantation Proceedings 11(1): 309-312
1979
ISSN/ISBN: 0041-1345 PMID: 377650 Document Number: 145332
Since November 1974, heterotopic cardiac transplants have been performed at this unit in preference to orthotopic transplants. A number of reasons have led us to prefer this technique, namely donor malfunction in the immediate postoperative period and during rejection; right ventricular failure of the donor heart in the orthotopic position in patients with pulmonary hypertension; the ease of patient management; and the use of the donor heart as a temporary method of cardiac support. Disadvantages are the later recognition of rejection and the difficulty in performing transvenous endomyocardial biopsies. The results are satisfactory giving a 1, 2, and 3-year survival rate of 62%, 58%, and 50%, respectively.