Heterotopic cardiac transplantation with a xenograft for assistance of the left heart in cardiogenic shock after cardiopulmonary bypass.
One of the indications for the use of the heterotopic cardiac transplant is temporarily to support a failing heart in the anticipation of its recovery when all other measures of support have been unsuccessful. Human donors are not always available when required and we decided to use a xenograft for this purpose when the need arose. This report details our experience with a baboon and a chimpanzee cardiac xenograft transplant in the heterotopic position. We have found (a) that the operation is technically feasible; (b) that the xenograft will support the failing circulation, but that the more support required, the bigger the xenograft should be and the species chosen accordingly; (c) that severe acute rejection will occur within 4 days and the procedure should therefore only be employed where there is evidence that the patient's own heart function will recover rapidly.
D000328:Adult; D000818:Animals; D001021:Aortic Valve; D001024:Aortic Valve Stenosis / Q000601:surgery; D002315:Cardiopulmonary Bypass; D005260:Female; D000882:Haplorhini; D016027:Heart Transplantation; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D002679:Pan troglodytes; D010215:Papio; D011183:Postoperative Complications / Q000601:surgery*; D012770:Shock, Cardiogenic / Q000601:surgery*; D014183:Transplantation, Heterologous