Key result
DCD heart transplant using prosthetic bicaval reconstruction succeeds in persistent left SVC.
Why the study?
Management strategies for heart transplantation in recipients with persistent left superior vena cava and complex venous anatomy are not well described.
Case Report (n=1)
No
Donation after circulatory death (DCD) heart transplantation can be successfully performed in a recipient with a persistent left superior vena cava using a modified bicaval technique with prosthetic conduits.
Single-case report of conduit technique for PLSVC in DCD transplant; leaves open generalizability and long-term safety.
A 60-year-old male with end-stage heart failure due to non-ischemic cardiomyopathy and mitral regurgitation presented for a donation after circulatory death (DCD) orthotopic heart transplantation. Intraoperatively, a persistent left superior vena cava (PLSVC), absent innominate vein, and small right superior vena cava were discovered. A bicaval technique was performed, using an interconnecting prosthetic conduit to anastomose the PLSVC with the right atrial appendage and an interposition graft to the native R SVC. After surgery, a transthoracic echocardiogram showed a left ventricular ejection fraction of 60-65% and improved systolic function. The postoperative course was uneventful, with discharge home after 16 days.
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Long et al. (2023) conducted a case report in End-stage heart failure with persistent left superior vena cava (n=1). Bicaval technique with prosthetic conduits for DCD heart transplant was evaluated on Postoperative cardiac function and recovery. A donation after circulatory death orthotopic heart transplant was successfully performed using a bicaval technique with prosthetic grafts in a patient with a persistent left superior vena cava.
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