Department of Cardiothoracic and Vascular Surgery, Rennes University Hospital, Rennes, France.
Eur J Cardiothorac Surg. 2013 Aug;44(2):201-6. doi: 10.1093/ejcts/ezt136. Epub 2013 Mar 13.
Orthotopic heart transplantation (OHT) is a well established and commonly utilized procedure for end-stage heart failure patients. Heterotopic heart transplantation (HHT) is a surgical procedure that allows the graft to be connected to the native heart in a parallel fashion. The main advantage of HHT is to assist the patient's native heart and to maintain circulation in the cases of severe acute rejection. HHT has also been proposed to overcome pulmonary hypertension, to increase the size of the donor pool and to decrease waiting times without increasing morbidity caused by the procedure. However, only a few papers have reported the short- or long-term results of HHT, and most of these studies have included <30 cases. OHT remains the standard technique and is preferable whenever the patient meets the current criteria and a suitable organ is available. HHT is far less useful than in the past because of the major advances in immunosuppression therapy and the development of long-term mechanical circulatory support. This study reviews the origin of HHT and discusses clinical developments, including their advantages and disadvantages.
原位心脏移植（OHT）是治疗终末期心力衰竭患者的一种成熟且常用的方法。异位心脏移植（HHT）是一种手术程序，可使移植物以并行的方式连接到患者的原生心脏。HHT 的主要优势在于辅助患者的原生心脏，并在严重急性排斥反应的情况下维持循环。HHT 也被提议用于克服肺动脉高压、增加供体池的大小并减少等待时间，而不会增加该手术引起的发病率。然而，只有少数几篇论文报告了 HHT 的短期或长期结果，而且这些研究大多数都包括<30 例病例。OHT 仍然是标准技术，只要患者符合当前标准且有合适的器官，就应优先考虑。由于免疫抑制治疗的重大进展和长期机械循环支持的发展，HHT 的用处远不如过去。本研究回顾了 HHT 的起源，并讨论了其临床发展，包括其优缺点。
