title: Bicaval anastomosis reduces tricuspid regurgitation after heart transplantation.
abstract: The standard surgical technique utilizing two atrial cuff anastomoses has been used in the majority of transplant centers until recently when bicaval anastomoses was introduced. The purpose of this study was to compare the prevalence of tricuspid regurgitation after the bicaval and standard techniques of anastomosis. Heart transplantation was performed in 43 patients at our institution from April 1994 to December 2003: 15 by the standard technique (group A) and 28 by the bicaval technique (group B). No differences in pre-transplant diagnosis, donor age, immunosuppression, rejection treatment, or graft ischemic time were evident between the two groups. The prevalence of tricuspid regurgitation (> or = moderate) was higher after the standard technique (36.4% vs. 10.5%; p < 0.05). Survival rates at 1 and 3 years in group A were 87% and 55%, and 86% and 78% in group B, with a significant difference in the 3-year mortality. The bicaval anastomosis technique was found to be associated with a lower incidence of tricuspid regurgitation during the late postoperative period, and should be preferred for heart transplantation.
authors.affiliation: Gil Heart Center, 1198 Kuwol-dong, Namdong-ku, Inchon 405-760, South Korea. kkyypark@ghil.com
authors.forename: Kook-Yang
authors.initials: KY
authors.lastname: Park
authors.forename: Chul-Hyun
authors.initials: CH
authors.lastname: Park
authors.forename: Yang-Bin
authors.initials: YB
authors.lastname: Chun
authors.forename: Mi-Seung
authors.initials: MS
authors.lastname: Shin
authors.forename: Kyung-Chun
authors.initials: KC
authors.lastname: Lee
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods*; D005260:Female; D016027:Heart Transplantation / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D006801:Humans; D015994:Incidence; D007723:Korea / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D013536:Suture Techniques; D014262:Tricuspid Valve Insufficiency / Q000209:etiology* / Q000401:mortality