Kitamura M, Hirota J, Fujino M, Fujino S, Endo M, Hashimoto A, Koyanagi H
Department of Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical College.
Kyobu Geka. 1991 Apr;44(4):299-302.
Para-esophageal anastomosis of left atrium was examined in orthotopic heart transplantation as a new surgical technique for transesophageal electrophysiologic study of the transplanted heart. Seven orthotopic heart transplantations were performed in mongrel dogs. Left atrial appendage of the donor heart was trimmed as a flap and the sinus venosus of right atrium was incised posteriorly. An upper midline incision was made in the posterior wall of left atrium of the recipient after native ventricles were resected. Left atrial appendage flap of the donor heart was anastomosed to the posterior incision of native left atrium, and the remains of left atrium were sutured continuously. Sinus venosus incision of the donor heart was anastomosed to the right atrium of recipient. Ascending aorta and pulmonary trunk were reconstructed in the standard fashion. Transesophageal atrial pacing was possible during and after weaning from cardiopulmonary bypass in all seven cases. The appendage flap was found to occupy one third of the posterior wall of left atrium at the time of sacrifice. It was suggested that para-esophageal anastomosis of left atrium would be an useful technique for transesophageal electrophysiologic study of the transplanted heart.
在原位心脏移植中检查左心房旁食管吻合术，作为一种用于移植心脏经食管电生理研究的新手术技术。对杂种犬进行了7例原位心脏移植。将供体心脏的左心耳修剪成皮瓣，右心房的静脉窦在后方切开。切除受体心脏的原生心室后，在左心房后壁做一个上中线切口。将供体心脏的左心耳皮瓣与受体原生左心房的后切口吻合，左心房的其余部分连续缝合。将供体心脏的静脉窦切口与受体的右心房吻合。升主动脉和肺动脉干按标准方式重建。在所有7例病例中，在脱离体外循环期间和之后都可以进行经食管心房起搏。在处死时发现皮瓣占据左心房后壁的三分之一。提示左心房旁食管吻合术将是用于移植心脏经食管电生理研究的一种有用技术。
