Which is the correct order of heart transplant anastomoses?

In heart transplantation, the sequence of anastomoses is crucial for the proper function of the transplanted organ and the overall success of the procedure. The correct order of heart transplant anastomoses starts with the left atrium (LA), followed by the pulmonary arteries (PA), then the aorta (Ao), afterward the inferior vena cava (IVC), and finishing with the superior vena cava (SVC).

Starting with the left atrium (LA) is important because it allows for a quick and efficient connection of the new heart to the existing pulmonary veins, facilitating immediate oxygenation of the blood as it returns from the lungs. After securing the left atrium, the pulmonary arteries (PA) are connected to ensure that deoxygenated blood is effectively directed from the right side of the heart to the lungs.

The aorta (Ao) is then anastomosed next; this connection is pivotal for distributing oxygen-rich blood to the body's tissues. Following the aorta, the inferior vena cava (IVC) is typically brought into contact to return deoxygenated blood from the lower body, which is then followed by the superior vena cava (SVC) for returning blood from the upper body.

This sequence is critical for promoting hemod