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Surgical Results of the Superior Vena Cava Intimal Layer-Only Suture Technique in Heart Transplantation

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Affiliated Author(s)
김윤석김재범박남희장우성김인철
Alternative Author(s)
Kim, Yun SeokKim, Jae BumPark, Nam HeeJang, Woo SungKim, In Cheol
Journal Title
J Chest Surg
ISSN
2765-1614
Issued Date
2023
Keyword
Superior vena cavaHeart transplantationStenosis
Abstract
Background:
Superior vena cava (SVC) stenosis during follow-up is a major concern after heart transplantation, and many technical modifications have been introduced. We analyzed the surgical results of the SVC intima layer-only suture technique in heart transplantation.

Methods:
We performed SVC anastomosis with sutures placed only in the intima during heart transplantation. We measured the area of the SVC at 3 different points (above the anastomosis, at the anastomosis, and below the anastomosis) in an axial view by freely drawing regions of interest, and then evaluated the degree of stenosis. Patients who underwent cardiac computed tomography (CT) at 2 years postoperatively between June 2017 and May 2020 were included in this study.

Results:
We performed heart transplantation in 41 patients. Among them, 24 patients (16 males and 8 females) underwent follow-up cardiac CT at 2 years postoperatively. The mean age at operation was 49.4±4.9 years. The diagnoses at time of operation were dilated cardiomyopathy (n=12), ischemic heart disease (n=8), valvular heart disease (n=2), hypertrophic cardiomyopathy (n=1), and congenital heart disease (n=1). No cases of postoperative bleeding requiring intervention occurred. The mean CT follow-up duration was 1.9±0.7 years. At follow-up, the mean areas at the 3 key points were 2.7±0.8 cm2, 2.7±0.8 cm2, and 2.7±1.0 cm2 (p=0.996). There were no SVC stenosis-related symptoms during follow-up.

Conclusion:
The suture technique using only the SVC intimal layer is a safe and effective method for use in heart transplantation.
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