[Heart transplant. Preservation and surgical technique. Eleven-year experience].
BACKGROUND
Heart transplantation is a treatment which has modified the long-term, survival and terminal heart failure patients. The objective of this work is to inform our experience with this surgical procedure.


METHODS
We analyzed the heart transplants realized between January 1, 1993 and November 30, 2004, the surgical techniques for harvest and implant and the procedure of heart preservation. The conventional approach for harvesting was median sternotomy with celiotomy in multiorgan donation. In main cases for preservation, we used the Bretschneider solution at 30 cc/ kg and 4 degrees C of temperature. For the implant of the heart the surgical techniques were biatrial or bicaval anastomosis.


RESULTS
A total of 16 heart transplantation was realized. The mean age of the recipients was 41 year-old (range: 15 a 57). In 68.7% the indication for the procedure was dilated idiopathic cardiomyopathy. The ischemic period was 154.6 +/- 63.9 min. There were 4 harvesting procedures out of the city. In 4 cases we used biatrial anastomosis, and in the other patients the bicaval procedure. We have three deaths for primary organ failure. The one-year survival was 80.2%.


CONCLUSIONS
Heart transplantation is a therapeutic option to improves long-term, survival in heart failure patients, and the results with the procedure we use are comparable to others around the world.
Careaga-Reyna
Guillermo
G
Hospital de Cardiologia. División de Cirugía, Centro Médico Nacional Siglo XXI, IMSS, México, DF. gcareaga3@aol.com
Jiménez-Valdivia
Maricela
M
Argüero-Sánchez
Rubén
R
D000293:Adolescent; D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000601:surgery; D005260:Female; D005947:Glucose; D016027:Heart Transplantation / Q000379:methods* / Q000401:mortality / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008353:Mannitol; D008800:Mexico; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011189:Potassium Chloride; D011343:Procaine; D012189:Retrospective Studies; D015996:Survival Rate; D014021:Tissue Preservation / Q000379:methods*; D020858:Tissue and Organ Harvesting / Q000379:methods*; D016896:Treatment Outcome
C039984:Bretschneider cardioplegic solution; D008353:Mannitol; D011343:Procaine; D011189:Potassium Chloride; D005947:Glucose