title: Over Ten Years of Experience with a Modified Right Atrial Anastomosis in Orthotopic Heart Transplantation: Follow-up and Comparison with the Biatrial and Bicaval Technique.
abstract: In 1997, a modified right atrial anastomosis (cavoatrial technique) for orthotopic heart transplantation (oHTx) was first developed in our institution. The purpose of this study is to report our long-term experience with this technique compared with biatrial and bicaval technique.
  
  
  
  Retrospectively, 202 consecutive oHTx between 1997 and 2013 were analyzed. The applied transplantation techniques were biatrial (n= 108), bicaval (n= 22), and cavoatrial (n= 72).
  
  
  
  Demographic data were similar in all groups. The cardiopulmonary bypass and cross-clamp time were significantly shorter in the biatrial group. Follow-up echocardiographic examination showed excellent results in all groups with no relevant differences. After 1 year, occurrence of severe tricuspid regurgitation (biatrial 1.9% vs bicaval 0.0% vs cavoatrial 1.4%) was low in all groups. Rate of permanent pacemaker implantations was also low (12.0% vs 5.0% vs 11.1%). There were no significant differences in survival between the groups.
  
  
  
  The cavoatrial technique can be a safe and simple alternative for heart transplantation. Easy handling and similar reduced postoperative complications encourage the use of this technique.
authors.affiliation: Department of Cardiovascular Surgery, University of Schleswig-Holstein Campus Kiel, Kiel, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Huenges
authors.affiliation: Department of Cardiovascular Surgery, University of Schleswig-Holstein Campus Kiel, Kiel, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Panholzer
authors.affiliation: Department of Cardiovascular Surgery, University of Schleswig-Holstein Campus Kiel, Kiel, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Fritzsche
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, University of Schleswig-Holstein Campus Kiel, Kiel, Germany.
authors.forename: Ole
authors.initials: O
authors.lastname: Broch
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, University of Schleswig-Holstein Campus Kiel, Kiel, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Renner
authors.affiliation: Department of Cardiovascular Surgery, University of Schleswig-Holstein Campus Kiel, Kiel, Germany.
authors.forename: Christine
authors.initials: C
authors.lastname: Friedrich
authors.affiliation: Department of Cardiovascular Surgery, University of Schleswig-Holstein Campus Kiel, Kiel, Germany.
authors.forename: Azizolah
authors.initials: A
authors.lastname: Rahimi-Barfeh
authors.affiliation: Department of Cardiovascular Surgery, University of Schleswig-Holstein Campus Kiel, Kiel, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Reinecke
authors.affiliation: Department of Cardiovascular Surgery, University of Schleswig-Holstein Campus Kiel, Kiel, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Cremer
authors.affiliation: Department of Cardiovascular Surgery, University of Schleswig-Holstein Campus Kiel, Kiel, Germany.
authors.forename: Assad
authors.initials: A
authors.lastname: Haneya
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D002315:Cardiopulmonary Bypass; D005260:Female; D006325:Heart Atria / Q000503:physiopathology / Q000637:transplantation*; D006333:Heart Failure / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D016027:Heart Transplantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000601:surgery*; D014683:Vena Cava, Superior / Q000601:surgery*; D055815:Young Adult