Bolman R M
Cardiovasc Clin. 1990;20(2):133-45.
The operative procedure of cardiac transplantation, whether orthotopic or heterotopic, must be performed with meticulous attention to technical detail and hemostasis. The price for technical misadventures and bleeding complications is high in terms of patient morbidity and mortality. Few cardiac surgical procedures are more straightforward than a heart transplant performed in a young individual who has not undergone previous cardiac surgery. Few greater technical challenges exist, however, than the patient in a state of precarious hemodynamic balance undergoing heart transplantation in the wake of one, two, or more previous cardiac surgical procedures. The principles outlined herein will serve as a foundation for the safe performance of cardiac transplantation regardless of the situation.
心脏移植手术，无论是原位移植还是异位移植，都必须极其注重技术细节和止血操作。技术失误和出血并发症会导致患者出现较高的发病率和死亡率。对于未接受过心脏手术的年轻患者而言，很少有心脏外科手术比心脏移植更简单直接。然而，对于之前接受过一次、两次或更多次心脏手术，处于血流动力学不稳定状态下接受心脏移植的患者来说，几乎没有比这更大的技术挑战了。无论何种情况，本文所述原则都将为安全开展心脏移植手术奠定基础。
