combined heart and lung transplantation

1. Primary pulmonary hypertension. 2. Eisenmenger syndrome. 3. Multiple pulmonary embolism. 4. Pulmonary fibrosis. 5. Chronic obstructive pulmonary disease. Treatment of diseases: pulmonary fibrosis primary pulmonary hypertension pulmonary embolism Indication 1. Primary pulmonary hypertension. 2. Eisenmenger syndrome. 3. Multiple pulmonary embolism. 4. Pulmonary fibrosis. 5. Chronic obstructive pulmonary disease. Surgical procedure (1) Removal of donor heart and lung: 1. The sternal midline incision. Heparin 300 U/kg was injected intravenously. Cardiac perfusion myocardial palsy solution 20ml/kg and perfusion lung protection solution 600mZ/kg. 2. Cut the vena cava at the right atrium. 3. Cut the ascending artery at the level of the innominate artery. 4. Cut off the trachea at 5 tracheal rings on the carina. 5. The isolated cardiopulmonary was placed in a 4 ° C Collins cold protection solution. The ischemic time was controlled within 6 hours. (B) Receptor cardiopulmonary resection: 1. The sternal midline incision. The thymus and the anterior wall of the pericardium are removed. Heparin 300 U/kg was injected intravenously to establish extracorporeal circulation. 2. Excision of the heart, the same method as heart transplantation. 3. The pericardium is removed from the left hilar to the diaphragm, and is cut longitudinally 2 to 3 cm in front of the left phrenic nerve; then the left iliac nerve is placed in the longitudinal direction of the left iliac crest, and the sacral nerve is completely retained on the pericardium. . 4. Cut the left pulmonary vein from the posterior wall of the left atrium. Pay attention to protecting the vagus nerve. 5. Cut the left pulmonary artery away from the arterial ligament. Do not damage the left recurrent laryngeal nerve. 6. Cut the left main bronchus and remove the left lung. 7. The same method is used to remove the right lung. (3) Implantation of donor heart and lung: 1. Place the left and right lungs in the chest after the left and right phrenic nerves. 2. The trachea was anastomosed with a 4-0 Prolene line interrupted end. The method is the same as before. 3. Use the 3-0 Prolene line to end the right atrium. 4. Continuous anastomosis of the aorta with a 4-0 Prolene line. Complete the implant anastomosis.

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