Successful aortic arch cannulation and perfusion of a heart donated after circulatory death: A case report.

Introduction: We describe successful aortic arch cannulation and perfusion of a heart donated after circulatory death using the Transmedics Organ Care System™.

Case report: A 47-year old man developed advanced heart failure symptoms after prior mustard operation for transposition of the great arteries. He matched a DCD-donor and required an elongated aorta for implantation due to his altered anatomy. The donor heart was retrieved and successfully perfused via aortic arch cannulation for 4.5 h with satisfactory perfusion parameters.

Disussion: Although Transmedics advises against aortic arch cannulation due to concerns regarding malperfusion, satisfactory and safe perfusion can be achieved by careful positioning of the heart. Awareness and attention to the occurrence of malperfusion is mandatory, especially during transport, to achieve satisfactory outcome.

Conclusion: Aortic arch cannulation is feasible without compromising quality of perfusion. This is relevant for patient that require an elongated aorta after surgically corrected congenital heart disease.