Medical Animation: Orthotopic Heart Transplantation | Cincinnati Children's

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Cincinnati Children’s Heart Institute- 513-636-4432

Heart Transplantation is a surgical transplant procedure that is performed when there is end-stage heart failure.

Most often in pediatrics, this occurs when there is failed medical or surgical palliation of congenital or acquired heart disease. In certain cases, heart transplantation may be the best or even the only option.

An orthotopic heart transplant consists of explanting or removing the patient’s heart and implanting a new heart from a deceased donor. In transplant medicine, “orthotopic” refers to placing a donor organ in its normal or usual position, and in this case, the failing heart is removed and the donor heart is placed in the exact same location.

This video illustrates an orthotopic, bicaval heart transplant in a patient with typical anatomy. The patient (also known as “transplant recipient”) is placed on cardiopulmonary bypass where deoxygenated venous blood is removed and receives fresh oxygen through a bypass circuit.

From there, the freshly oxygenated blood is run through a “pump” back to the aorta to continuously give oxygen to vital organs during the whole procedure.

Once on bypass, the failing heart can be removed. Special care must be taken while removing the heart because certain heart tissue and vessels are very important to reattach the new donor heart to.

While all of this is going on, a separate team works simultaneously to acquire the donor heart and transport it to the recipient’s location. Once the new donor heart arrives, it is sewn in place starting with the left atrium and followed by the aorta so that the cross-clamp can be removed and the new heart can begin receiving and pumping blood again without the assistance of the bypass machine.

Once the coronaries of the new donor heart are given fresh oxygenated blood, the new donor heart begins to beat again. The pulmonary artery, inferior vena cava, superior vena cava are then sewn into place and the patient is weaned off cardiopulmonary bypass to complete the procedure.

Credits: Media Lab at Cincinnati Children’s (@CincyKidsMedArt)
Animation: Jeff Cimprich, Matt Nelson, and Julia Bendon
Media Lab Direction: Ken Tegtmeyer MD & Ryan Moore MD
Content Experts: David Morales MD & Ryan Moore MD
Voice Over: David Morales MD