Clinical and experimental observations in heart transplantations.

As described previously,lS2 this was a modification of the Lower-Shumway method? In brief, pairs of puppies were chosen on the basis of approximate match in weight, anesthetized and subjected to hypothermia of 15 to 20°C. for the recipient, and 25 to 30°C. for the donor. The excised donor heart was stored in isotonic solution at 4 to 10°C. while preparation of the recipient was completed. The recipient’s chest was opened bilaterally through the anterior fourth intercostal space. After complete circulatory arrest by inflow-outflow occlusion the heart was excised by transecting the pulmonary artery and aorta close to the valves and by severing the auricles close to the ventricles. To implant the donor heart, a continuous over-and-over suture was used to approximate the auricular walls and septum. The recipient’s aorta and pulmonary artery were then joined to the donor vessels. Peestablishment of circulation by cardiac massage, controlled respiration, blood replacement, treatment of metabolic acidosis,