Heart transplantation—report of a case

Author and Disclosure Information


IMPLANTATION of a homograft heart offers a chance of survival to each one of a selected group of patients with severe and intractable cardiac disease. The significant experimental work done in the past by Dong and associates,1 and by Lower, Dong, and Shumway,2 and the recent successful clinical results obtained by Barnard3 have demonstrated the feasibility of cardiac transplantation and encourage further clinical application. Our report concerns our experience with the first patient in whom we performed a heart transplantation.

Report of a case

A 49-year-old Caucasian man was admitted to the Cleveland Clinic Hospital on March 20, 1968, because of severe cardiac dysfunction. He had a heart murmur since infancy, and was rejected by the United States Army during World War II because of what was thought to be rheumatic heart disease. He had engaged in heavy labor without distress until the last year (1967), when he began to experience dyspnea on exertion, orthopnea, and episodes of paroxysmal nocturnal dyspnea. In October of 1967 he experienced a half-hour episode of substernal chest pain which recurred several times. He was unable to work since that time. Physical examination revealed that the blood pressure was 100/70 mm Hg, and the pulse was 96 beats per minute and regular. The neck veins were flat when the patient was in a sitting position. The lungs were clear, and the heart showed an apical thrill, grades 3 to 6. There was a holo-systolic murmur at the apex radiating to the axilla, and grades 2 . . .



Next Article: