Barnard C N, Wolpowitz A
Transplant Proc. 1979 Mar;11(1):309-12.
Since November 1974, heterotopic cardiac transplants have been performed at this unit in preference to orthotopic transplants. A number of reasons have led us to prefer this technique, namely donor malfunction in the immediate postoperative period and during rejection; right ventricular failure of the donor heart in the orthotopic position in patients with pulmonary hypertension; the ease of patient management; and the use of the donor heart as a temporary method of cardiac support. Disadvantages are the later recognition of rejection and the difficulty in performing transvenous endomyocardial biopsies. The results are satisfactory giving a 1, 2, and 3-year survival rate of 62%, 58%, and 50%, respectively.
自1974年11月以来，本单位优先进行异位心脏移植而非原位移植。有多种原因促使我们倾向于采用这种技术，即术后即刻及排斥反应期间供体功能障碍；肺动脉高压患者原位供体心脏出现右心室衰竭；患者管理简便；以及将供体心脏用作心脏支持的临时方法。缺点是排斥反应较晚被识别以及经静脉心内膜活检操作困难。结果令人满意，1年、2年和3年生存率分别为62%、58%和50%。
