Rare heart autotransplantation performed at Sechenov University

Rare heart autotransplantation performed at Sechenov University

One of the recent achievements in our clinical practice is a successful case of cardiac autotransplantation performed on a patient with severely altered atria. The exceptional surgery was done by Prof Roman Komarov, Director of Burdenko Clinic of Faculty Surgery, Head of the Department of Aortic Surgery, and Head of the Department of Cardiovascular Surgery and Invasive Cardiology at Sechenov University.

The patient, a 64-year-old man, was admitted to clinic with chronic heart failure and arrhythmia. He also had significantly enlarged atria. The condition was very serious, and the prognosis was that — without intervention — the patient could die within 2 months.

The medical team decided to go ahead with cardiac autotransplantation. This is a very serious procedure in which the heart is explanted for operation and then re-installed in its place.

During the surgery, both atria were adjusted to the normal size, and the heart valves were restored.

It took 8 hours in total, and the patient’s heart remained outside the body for 3 hours.

Cardiac autotransplantation, while being very challenging overall, is more commonly recommended for patients with malignant tumours in the heart which cannot be treated by other methods. However, valve dysfunction and some other conditions that trigger pathophysiological changes to the atrial structure and function — especially in cases with severe dilatation — may require the surgery when conservative treatment fails. Still, cardiac autotransplantation remains an extremely difficult and risky operation, and only exceptional, brilliant surgeons attempt to perform it.

It is estimated that very few such surgeries have ever been performed in Russia.

‘Heart autotransplantation is much more laborious than heterotransplantation — when the patient receives the heart from another person’, explains Roman Komarov.

He compares the procedure with the works at an automobile repair shop, where it is possible to take out the car’s engine, tune it up, and put it back — without installing a new one.

‘In our case, we needed to carry out a complete reconstruction of the damaged “engine”. Cardiac surgeons are generally reluctant to perform autotransplantation because it is very laborious — but we had no choice. This was the only way to save the patient’s life’, adds Roman Komarov.

The patient is doing well and will be monitored further — but it is already clear that his heart is working just as it should.

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Роман Николаевич Комаров

д.м.н., заведующий кафедрой Сердечно-сосудистой хирургии

тел.:+7 (916)-730-53-38

7 этаж, каб. 717, 732

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моб.: +7(902)-288-46-56