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Review
. 2025 May 15;21(3):25-32.
doi: 10.14797/mdcvj.1572. eCollection 2025.

The Evolution of the Heart Transplant Surgical Technique

Mehmet H Akay  1 , Erik E Suarez  1 , O H Frazier  2
Affiliations
Review

The Evolution of the Heart Transplant Surgical Technique

Mehmet H Akay et al. Methodist Debakey Cardiovasc J. .

Abstract

This overview of the history of human cardiac transplant shares detailed illustrations to demonstrate how surgical procedures have improved since the first human transplant was performed in 1967 in Cape Town, South Africa.

Keywords: heart transplantation; heterotopic; orthotopic; surgical evolution.

PubMed Disclaimer

Conflict of interest statement

The authors have no competing interests to declare.

Figures

Shumway’s donor cardiectomy dividing the left atrial cuff
Figure 1
Shumway’s donor cardiectomy dividing the left atrial cuff. Reprinted from Morton Bolman R. Oper Tech Thorac Cardiovasc Surg. 1999 May;4(2):98-113. ©1999, with permission from Elsevier.
Shumway’s donor cardiectomy dividing the anterior vessels
Figure 2
Shumway’s donor cardiectomy dividing the anterior vessels. Reprinted from Morton Bolman R. Oper Tech Thorac Cardiovasc Surg. 1999 May;4(2):98-113. ©1999, with permission from Elsevier.
Biatrial technique for the recipient’s cardiectomy
Figure 3
Biatrial technique completed for the recipient’s cardiectomy. Reprinted from Morton Bolman R. Oper Tech Thorac Cardiovasc Surg. 1999 May;4(2):98-113. ©1999, with permission from Elsevier.
Biatrial technique using left atrial anastomosis
Figure 4
Biatrial technique using left atrial anastomosis. Reprinted from Morton Bolman R. Oper Tech Thorac Cardiovasc Surg. 1999 May;4(2):98-113. ©1999, with permission from Elsevier.
Biatrial technique using right atrial anastomosis
Figure 5
Biatrial technique using right atrial anastomosis. Reprinted from Morton Bolman R. Oper Tech Thorac Cardiovasc Surg. 1999 May;4(2):98-113. ©1999, with permission from Elsevier.
Pulmonary artery and aortic anastomoses for biatrial technique
Figure 6
Pulmonary artery and aortic anastomoses used in biatrial technique. Reprinted from Morton Bolman R. Oper Tech Thorac Cardiovasc Surg. 1999 May;4(2):98-113. ©1999, with permission from Elsevier.
All the anastomoses completed for the biatrial technique
Figure 7
All the anastomoses are completed for the biatrial technique. Reprinted from Morton Bolman R. Oper Tech Thorac Cardiovasc Surg. 1999 May;4(2):98-113. ©1999, with permission from Elsevier.
Donor cardiectomy for bicaval implantation
Figure 8
Donor cardiectomy used for bicaval implantation. Reprinted from John R, Liao K. Orthotopic Heart Transplantation. Oper Tech Thorac Cardiovasc Surg. 2010;15(2):138-146. ©2010, with permission from Elsevier.
Recipient mediastinum after cardiectomy
Figure 9
Recipient mediastinum after cardiectomy. Reprinted from John R, Liao K. Orthotopic Heart Transplantation. Oper Tech Thorac Cardiovasc Surg. 2010;15(2):138-146. ©2010, with permission from Elsevier. LA: left atrium; PA: pulmonary artery; Ao: aorta; SVC: superior vena cava
Bicaval technique using left atrial anastomosis
Figure 10
Bicaval technique using left atrial anastomosis. Reprinted from John R, Liao K. Orthotopic Heart Transplantation. Oper Tech Thorac Cardiovasc Surg. 2010;15(2):138-146. ©2010, with permission from Elsevier. LAA: left atrial appendage; LA: left atrium; PA: pulmonary artery
Inferior and superior vena cavae anastomosis for bicaval technique
Figure 11
Inferior and superior vena cavae anastomosis used for bicaval technique. Reprinted from John R, Liao K. Orthotopic Heart Transplantation. Oper Tech Thorac Cardiovasc Surg. 2010;15(2):138-146. ©2010, with permission from Elsevier.
Aorta and pulmonary artery anastomosis for bicaval technique
Figure 12
Aorta and pulmonary artery anastomosis used for bicaval technique. Reprinted from John R, Liao K. Orthotopic Heart Transplantation. Oper Tech Thorac Cardiovasc Surg. 2010;15(2):138-146. ©2010, with permission from Elsevier.
All the anastomosis for the bicaval technique
Figure 13
All the anastomosis are completed for the bicaval technique. Reprinted from John R, Liao K. Orthotopic Heart Transplantation. Oper Tech Thorac Cardiovasc Surg. 2010;15(2):138-146. ©2010, with permission from Elsevier.
See this image and copyright information in PMC

References

    1. Barnard CN. The operation. A human cardiac transplant: an interim report of a successful operation performed at Groote Schuur Hospital, Cape Town. S Afr Med J. 1967. Dec 30;41:1271-4. PMID: 4170370 - PubMed
    1. Lower RR, Shumway NE. Studies on the orthotopic homotransplantation of the canine heart. Surg Forum. 1960;11:18-9. PMID: 13763847 - PubMed
    1. Morton Bolman R. Heart Transplantation Technique. Oper Tech Thorac Cardiovasc Surg. 1999. May;4(2):98-113. doi: 10.1016/S1522-2942(07)70108-3 - DOI
    1. Matskeplishvili S. Vladimir Petrovich Demikhov (1916-1998): A pioneer of transplantation ahead of his time, who lived out the end of his life as an unknown and in poor circumstances. Eur Heart J. 2017. Dec 7;38(46):3406-3410. doi: 10.1093/eurheartj/ehx697 - DOI - PubMed
    1. Cooper DK. Transplantation of the heart and both lungs. I. Historical review. Thorax. 1969. Jul;24(4):383-90. doi: 10.1136/thx.24.4.383 - DOI - PMC - PubMed

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