Abertura do sulco interatrial na retirada de enxertos múltiplos para transplante de coração e pulmões: estudo anatômico

Miguel Lia Tedde,Aldo Junqueira Rodrigues Júnior,Fábio Biscegli Jatene

doi:10.1590/s0102-76382008000200013

Miguel Lia Tedde, Aldo Junqueira Rodrigues Júnior + Show 1 more

Open Access

https://doi.org/10.1590/s0102-76382008000200013

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Abstract

To evaluate the impact of the interatrial sulcus opening regarding of left atrium gain when harvesting heart and lungs for transplantation. It was evaluated the left atrium dimension, from the right mediastinal side, after the interatrial sulcus dissection in fifty human cadaver. The interatrial sulcus gain was related with gender, age and ethnic group. The gain observed through right interatrial opening was, in media, 1.31 cm (0.3 cm to 2.5 cm). When that value was related to the variable gender it was observed that in the 27 (54%) cases of the male the earnings was 1.19 cm +/- 0.6 cm and, in the 23 (46%) female, 1.21 cm +/- 0.5 cm (p = 0.895). In relation to age, it was observed that, in the 24 (48%) cases with smaller age than 50 years, the value was 1.08 cm +0.6 cm and, in the 26 (52%) with larger age or same to 50 years, 1.36 cm +/- 0.6 cm (p = 0.088). In relation to ethnic group, it was observed that the value of the earnings in the 31 (62%) cases of whites it was 1.34 cm +/- 0.5 cm and, in the 19 (38%) non white, 1.27 cm +/- 0.4 cm (p = 0.589). Heart grafts and lung grafts must be harvested maintaining adequate segments of left atrium near the heart and the pulmonary veins of the lungs that will be transplanted. Although there is no correlation between the observed gain in the interatrial sulcus dissection and the variables gender, age and ethnic group, our results confirm that the interatrial sulcus opening can give access to significant extension of left atrium wall when separating heart and lungs.

Highlights

IntroductionCircumstantial conditions may contribute to a renewed interest in anatomical aspects that, previously studied, result in new perspectives today
Some relatively recent procedure techniques, such as heart and lung transplants, are already well established [1,2,3,4,5].circumstantial conditions may contribute to a renewed interest in anatomical aspects that, previously studied, result in new perspectives today
There is no correlation between the observed gain in the interatrial sulcus dissection and the variables gender, age and ethnic group, our results confirm that the interatrial sulcus opening can give access to significant extension of left atrium wall when separating heart and lungs

Summary

Introduction

Circumstantial conditions may contribute to a renewed interest in anatomical aspects that, previously studied, result in new perspectives today. One of these circumstances is the need to optimize the organs harvesting for transplant from a single donor due to the donors shortage [6.7]. The left atrium is one of the factors mentioned in the literature that limits the harvesting of a cardiac graft and two lung grafts from a single donor This occurs because surgical techniques for lung implants in recipients recommend that venous anastomosis of the lung grafts should be performed using sutures in the atrial segment that covers the two pulmonary veins. We propose the opening of the interatrial sulcus in order to minimize this technical difficulty

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