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May 1969

Cardiac Transplantation as Palliation of Advanced Heart Disease

Author Affiliations

From the Cora and Webb Mading Department of Surgery (Drs. Cooley, Hallman, and Bloodwell), the departments of medicine (Dr. Leachman) and pediatrics (Dr. Nora), Baylor University College of Medicine and the Texas Heart Institute of St. Luke's and Texas Children's Hospitals, Houston.

Arch Surg. 1969;98(5):619-625. doi:10.1001/archsurg.1969.01340110111012

In spite of striking advances in surgical treatment of heart disease, large numbers of patients with acquired cardiac pathologic conditions or congenital anomalies remain uncorrectable. Cardiac transplantation may represent the only feasible form of surgical treatment in these patients. Since May 2, 1968, we have performed 14 human heart transplants, one combined heartlung transplant, and one xenograft using a sheep's heart. This paper details our experience with these patients.

Surgical Technique  A median sternotomy is made, heparin administered (3 mg/kg of body weight), and preparations made for cardiopulmonary bypass by cannulation of both superior and inferior venae cava. Metal caval cannulae with angled tips ensure against kinking. A catheter placed in the common femoral artery provides return of arterial blood from the pump oxygenator. In some cases the ascending aorta is preferable, as in an infant with a small femoral artery. The inferior vena cava may be cannulated through the

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