SIMPLIFIED TECHNIQUE OF HEART-LUNG TRANSPLANTATION

Well-known complications of heart-lung transplantation include mediast inal bleeding and phrenic nerve injury. Conventional technique places the hila behind the phrenic nerves. We have placed the hila in front o f the phrenic nerve in our last 10 patients, using direct caval anasto moses when feasible. This minimizes traction on and dissection around the phrenic nerves, and allows anterior rotation of the heart-lung blo ck for easier hemostasis of the posterior mediastinum after implantati on.