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A lost art-The biatrial technique for adult orthotopic heart transplantation.

Created on 11 Aug 2026

Authors

Aaron M Williams, Chen Chia Wang, Kevin C McGann, John Trahanas, Awab Ahmad, Brian Lima, Amir T Dereshgi, Tarek Absi, Eric Quintana, Matthew Bacchetta, Ashish S Shah, Swaroop Bommareddi

Published in

JTCVS techniques. Volume 38. Pages 102427. Epub May 25, 2026.

Abstract

The biatrial anastomosis technique was the original method of performing orthotopic heart transplantation. More recently, bicaval implant has become the preferred technique of choice. However, situations such as a complex redo sternotomy or size mismatch between donor and recipient vena cava may necessitate the use of the biatrial technique.
This article highlights our institutional biatrial implant technique to ensure modern heart transplant surgeons retain proficiency in this method of heart transplantation.
Although the pacemaker rates in the biatrial cohort were greater than that in our bicaval cohort, the rates of tricuspid regurgitation and right ventricular dysfunction were similar.
Our manuscript highlights the timing of a biatrial heart transplant and details the operative steps necessary to avoid significant atrial or valvular distortion.

PMID:
42577183
Bibliographic data and abstract were imported from PubMed on 11 Aug 2026.

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