An echocardiographic and anatomic description of the donor-recipient atrial anastomosis after orthotopic cardiac transplantation

Abstract Cardiac transplantation has become the standard of care for many patients afflicted with end-stage congestive heart failure. Approximately 2,200 cardiac transplants were performed worldwide in 1987. 1 Infection, cardiovascular disease (graft atherosclerosis or failure) and acute rejection account for the vast majority of deaths and morbidity in cardiac transplant recipients. At our institution, we observed acute cerebrovascular events in 2 of the first 12 patients transplanted. A detailed 2-dimensional echocardiographic examination was performed to exclude an underlying cardiac etiology. This report describes a unique echocardiographic finding that is observed in orthotopic cardiac transplant recipients. We report the results of a prospective analysis that defines the frequency of this echocardiographic finding and propose an anatomic explanation for this observation. The clinical significance of this newly described finding is discussed.