Surgical Treatments
Normal Heart and Lungs
A brief review of the anatomy and physiology of your heart and lungs may assist you in understanding how these organs work.
Your body is made up of billions of specialized cells arranged in groups to perform various functions. Your cells can only survive in an environment that receives oxygen for metabolism and removes waste products in the form of carbon dioxide. Your heart is the pump that moves blood throughout the body.
Your heart is made up of four chambers: right and left atria, and right and left ventricles. Unoxygenated blood returns from your head and body and enters your heart at the right atrium through the inferior and superior venae cavae. It then enters the right ventricle where it is pumped to the lungs through the pulmonary artery to be oxygenated. It is in your lungs where the gaseous exchange between oxygen and carbon dioxide occurs.
The oxygenated blood returns from your lungs to the left atrium through the pulmonary veins. It then enters the largest and most muscular chamber, the left ventricle, from which blood is pumped out to your body through the aorta and its many branches.
Transplantation Procedure
At the time of transplant surgery (called transplantation) your old heart is removed, and the back portions of your right and left atria are left intact for suturing. The incision lines of your transplanted heart are made at the mid-atrial level, preserving the inferior and superior venae cavae and pulmonary vein connections. The pulmonary artery and aorta are severed just above the aortic and pulmonary valves and your old heart is removed. (Fig. 2)
In the combined heart and lung transplantation, the entire block of your heart and both lungs are removed together. The incisions on your atria and aorta are similar to those done with heart-only transplantation. An incision is made in the windpipe (trachea) below the vocal cords and above its division into the right and left main bronchi, allowing both lungs to be removed along with the heart. (Fig. 3)
In a single lung transplant one main stem bronchus is divided just before its first branch point and that lung is removed. After removal of the lung, the donor lung is placed in the chest and the donor and recipient bronchus, pulmonary arteries and pulmonary veins are sutured together to re-establish "normal" anatomic relations. (Fig. 4)
A double lung transplant is achieved by performing bilateral single lung procedures, the same operation described above, except performed on each lung. (Fig. 5)
Corrective surgery for heart abnormalities may need to be done with either single or double lung transplant.
With any type of cardiopulmonary transplant surgery, the same operation is performed on the donor. The donor's healthy organ(s) are removed and sutured into you to replace the diseased organ(s).