This is the first study to compare the incidence and severity of transplant coronary artery disease in heart-lung and heart transplant recipients with the use of ICUS. The results of this study show that the incidence and severity of transplant coronary artery disease are less in heart-lung transplant recipients than in heart transplant recipients.. A major cause of mortality, and the main cause of retransplantation in heart transplant recipients, is transplant coronary artery disease. As many as 50% of the patients will develop significant angiographic disease by 5 years after transplantation. The majority of the heart-lung transplant recipients who survive the first year do not die as the result of cardiac disease or event.8 9 12 The present study confirms earlier reports that indicate that transplant coronary artery disease, as assessed by quantitative coronary angiography, does not play a major role in the morbidity and mortality of heart-lung transplant recipients. Richardson et al8 ...
TY - JOUR. T1 - Pediatric heart-lung transplantation. T2 - Intermediate-term results. AU - Conte, J. V.. AU - Robbins, R. C.. AU - Reichenspurner, H.. AU - Valentine, V. G.. AU - Theodore, J.. AU - Reitz, B. A.. PY - 1996. Y1 - 1996. N2 - Background: Adult heart-lung transplantation was initiated at Stanford in 1981 and the first pediatric heart-lung transplantation was done in 1986. Intermediate-term results of pediatric heart-lung transplantation at Stanford University are presented. Methods: A retrospective review of the records of all pediatric heart-lung transplantations done since 1986 was conducted. Results: Nineteen heart-lung transplantations were done in 17 patients. Ages ranged from 2 months to 18 years with a median age of 10 years. At the time of transplantation 5 patients were infants, 7 children, and 7 adolescents. The mean follow-up was 29 ± 6.2 months (range 1 to 77, median 16) and follow-up was 100% complete. Diagnoses were congenital heart disease in 13, primary pulmonary ...
TY - JOUR. T1 - Mycoplasma hominis periaortic abscess following heart-lung transplantation. AU - Hagiya, Hideharu. AU - Yoshida, Hisao. AU - Yamamoto, Norihisa. AU - Kimura, Keigo. AU - Ueda, Akiko. AU - Nishi, Isao. AU - Akeda, Yukihiro. AU - Tomono, Kazunori. PY - 2017/6. Y1 - 2017/6. N2 - We report the first case of Mycoplasma hominis periaortic abscess after heart-lung transplantation. The absence of sternal wound infection delayed the diagnosis, but the patient successfully recovered with debridement surgeries and long-term antibiotic therapy. Owing to the difficulty in detection and the intrinsic resistance to beta-lactams, M. hominis infections are prone to being misdiagnosed and undertreated. M. hominis should be suspected in cases where conventional microbiological identification and treatment approaches fail.. AB - We report the first case of Mycoplasma hominis periaortic abscess after heart-lung transplantation. The absence of sternal wound infection delayed the diagnosis, but the ...
There are factors which absolutely contraindicate (rule out) heart-lung transplantation, including multiple organ system dysfunction, current substance abuse, bone marrow failure, active malignancy, and HIV infection. Other relative contraindications include age greater than 55, anorexia, obesity, peripheral and coronary vascular disease, ventilator support, steroid dependency, chest wall deformity, and resistant infections by bacterial and fungal agents. Mental health status should be addressed, as well. Patients who are limited in daily activity, as defined by their doctors, and have a limited life expectancy, are candidates for heart-lung transplantation. These patients suffer from untreatable end-stage pulmonary, organ, and/or vascular disease. Most often, the diagnosis includes primary pulmonary hypertension brought on by congenital blood vessel defects that include malformations in the lung. Congenital cardiac defects and other diseases may also be responsible. Donor matching is managed by ...
Accelerated coronary artery disease is a major cause of mortality in heart transplant recipients; however, it does not appear to play a major role in the clinical outcome of heart-lung transplant recipients. The purpose of this study was to determine whether the incidence and severity of transplant coronary artery disease as detected by intracoronary ultrasound in heart-lung transplant recipients are less than those encountered in heart transplant recipients.We studied the left anterior descending coronary artery with the use of intracoronary ultrasound imaging in 22 heart-lung transplant recipients at the time of their routine annual coronary angiogram. Twenty-two heart transplant recipients were case matched for number of years after transplant at ultrasound study, recipient age, donor age, and diagnosis of nonischemic cardiomyopathy. Mean intimal area, intimal index, Stanford class, and incidence of at least moderate disease (Stanford class , or = 3) were measured and calculated in each group ...
During the last 20 years, there has been a shift away from combined heart-lung transplantation (HLT) in favor of bilateral lung transplantation. This paradigm shift allowed for the donor heart to be t
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TY - JOUR. T1 - Transitioning from pediatric to adult care after thoracic transplantation. AU - Putschoegl, Adam. AU - Dipchand, Anne I.. AU - Ross, Heather. AU - Chaparro, Cecilia. AU - Johnson, Jonathan N.. PY - 2017/8/1. Y1 - 2017/8/1. N2 - With improving outcomes after thoracic transplantation, more children are surviving to adulthood and requiring specialized adult care. A systematic and effective program is essential to transition these patients from a pediatric to adult health care setting. In this review, we discuss the concept of transition and the factors leading to an effective transfer to an adult care provider, including administrative support, patient/provider preparation, and the navigation of potential barriers. Notably, there is a paucity of data for many details of transition, making this a significant opportunity for future research.. AB - With improving outcomes after thoracic transplantation, more children are surviving to adulthood and requiring specialized adult care. A ...
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... Helps students or patients to understand the relationship between the larynx, heart and lungs; life-size, Can be disassembled into 7 parts - The lungs have two removable lobes to show the internal structures. The heart bisects show the atria, ventricles and valves. The larynx bisects as well and the diaphragm is shown. This model comes with a base and is made of high-quality PVC, durable. 272011cm/10.637.874.33 inch - Material: Premium PVC - Color: As Shown. 1 Piece Larynx Heart Lung Model. Please verify your address during checkout. We are not responsible for any wrong or undeliverable addresses. People always bought together with. The item "Life-Size Human Larynx Heart Lung Anatomical Model Medical Anatomy, 7 Parts" is in sale since Sunday, January 6, 2019. This item is in the category "Business & Industrial\Healthcare, Lab & Dental\Medical, Lab & Dental Supplies\Anatomical Models". The seller is "alpinetopline" and ...
The optimal timing for transplantation is unclear in patients with Eisenmenger syndrome (ES). We investigated post-transplantation survival and transplantation-specific morbidity after heart-lung transplantation (HLTx) or lung transplantation (LTx) in a cohort of Nordic patients with ES to aid decision-making for scheduling transplantation.We performed a retrospective, descriptive, population-based study of patients with ES who underwent transplantation from 1985 to 2012.Among 714 patients with ES in the Nordic region, 63 (9%) underwent transplantation. The median age at transplantation was 31.9 (IQR 21.1-42.3) years. Within 30 days after transplantation, seven patients (11%) died. The median survival was 12.0 (95% CI 7.6 to 16.4) years and the overall 1-year, 5-year, 10-year and 15-year survival rates were 84.1%, 69.7%, 55.8% and 40.6%, respectively. For patients alive 1 year post-transplantation, the median conditional survival was 14.8 years (95% CI 8.0 to 21.8), with 5-year, 10-year and ...
I want to do more stuff, Spencer Kolman said. His voice was a whisper, a painful-to-hear rasp across the telephone line. Im a Boy Scout, so I want to go back and get my Eagle Scout and do ...
Background. French patients with severe pulmonary hypertension (PH) and imminent risk of death can access to heart-lung transplantation (HLT) or lung transplantation (LT) according to a high urgency allocation program (HUAP) since September 2006 and July 2007 respectively.. Objective and methods. To report results of HLT and LT in PH patients listed on HUAP from 2007 to 2012. Characteristics and outcome of these patients were retrospectively analyzed and compared to the cohort of PH patients receiving non-urgent (NU) HLT or LT.. Results. During the study period, 28/42 (67%) HLT and 24/53 (45%) LT were performed according to the HUAP. Based on the clinical classification of PH 64% of patients were group 1 (pulmonary arterial hypertension), 18% group 1 (veno-occlusive disease), 2% group 3, 8% group 4 and 7% group 5. Total median time on waiting list was 0.3 months (IQR 25-75%, 0.1-2.7) and 3.6 months (IQR 25-75%, 2-12) in HUAP and NU groups respectively (p,0.01). Median numbers of death per year ...
Chief Cardiothoracic, Transplant and Minimal Access Cardiac Surgeon Dr Gokhale did the 1st successful heart transplant, first successful lung transplant and 1st successful implantation of ventricular assist device in the states of Telangana and Andhra Pradesh. He has one of the largest experiences in minimally invasive heart surgery in India. So far he did more than 10,000 open heart surgeries - adult as well as pediatric. ...
Professor Sharon Hunt, MD, is recognized by the society for her relentless efforts to bring heart transplantation medicine from its inception at Stanford to its current excellence, for her legacy in training and mentoring the many international leaders in our field, for her countless past and ongoing scientific contributions including spearheading the most comprehensive guidelines in heart failure and transplantation, and for her untiring service to the ISHLT as President, Chair of the JHLT Editor Search Committee, Co-Chair of the Heart Transplant International Guidelines Committee and most recently as Chair of the US-based ABIM certification board in Advanced HF and Transplant Cardiology (a certification that has legitimized the field in the US ...
ISHLT Endorsement is available only for meetings whose content has been determined by ISHLT to focus on 1) improving the care of patients with advanced heart or lung disease through transplantation, mechanical support and innovative therapies or 2) improving access to advanced therapies for end-stage lung or heart disease ...
Dr. Adrian Kantrowitz performed the first human heart transplant in the United States in 1967 and pioneered the development of mechanical devices to prolong the life of patients with heart failure. Over six decades of surgical practice, he designed and used more than 20 medical devices that aided circulation and other vital functions. In 1971, Adrian successfully implanted a ventricular assist device in a man suffering from chronic heart failure who returned home as the worlds first recipient of a left ventricular assist device intended to remain permanently in the body.. ...
Pulmonary hypertension is one of the indications for lung transplantation. Recent advances on medical management of the disease have dramatically decreased the number of patients who required lung transplantation. In reported series, single or double lung transplantation have been successfully undertaken by many transplant centers. In patients, whose cardiac functions are irreversibly damaged heart-lung transplantation remains as an only option for long term survival. Transplantation should only be considered in those patients who are having optimal medical support and relatively good condition for a major operation.
An In-Kind Educational Grant is foundational support from ISHLT to another organization in the form of up to 8 hours of medical or scientific educational program content, including educational format, session topics, presentation titles, teaching points, recommended speakers, and recommended session chairs, for the other organizations use in conducting a meeting exclusively for educational purposes. The development of individual presentation content is not a part of the In-Kind Educational Grant and is the responsibility of the faculty selected for the event ...
Patients with primary pulmonary hypertension (PPH) pose a difficult management problem. There are few effective therapies. The disease is progressive, with increasing pulmonary vascular resistance (PVR) and pressures, resulting in right heart failure, dyspnea and decreasing functional status. Untreated, the mortality rate is substantial, and life expectancy after the development of congestive heart failure (CHF) can be measured in months. In a group of 90 patients with PPH referred for heart-lung transplantation, the mean survival from diagnosis was 42.9 ± 42.6 months, with a symptom duration of 65.9 ± 47.4 months [1]. In a national registry of 194 patients from 32 centers with PPH, the median survival was 2.8 years [2]. In patients with a cardiac index ,2 liters/min per m2, the median survival was 17 months, and if the right atrial pressure (RAP) was ,20 mm Hg, it was 1 month without therapy. Using this hemodynamic data (RAP, mean pulmonary artery pressure and cardiac index), equations were ...
OBJECTIVE--To assess relations between right ventricular pressure measured with a high fidelity transducer tipped catheter and the characteristics of tricuspid regurgitation recorded with Doppler echocardiography. DESIGN--A prospective non-randomised study of patients with severe pulmonary hypertension referred for consideration of lung transplantation. SETTING--A tertiary referral centre for cardiac and pulmonary disease, with facilities for invasive and non-invasive investigation, and assessment for heart and heart-lung transplantation. PATIENTS--10 patients with severe pulmonary hypertension being considered for lung transplantation. ENDPOINTS--Peak right ventricular, pulmonary artery, and right atrial pressures; peak positive and negative right ventricular dP/dt; peak Doppler right ventricular-right atrial pressure drop; Doppler derived peak positive and negative right ventricular dP/dt; and time intervals of Q to peak right ventricular pressure and to peak positive and negative right ...
Main objective : This project aims to assess the educational needs of patients who received a lung transplantation or a simultaneous heart-lung transplantation for mucoviscidosis.. Specific objectives : Evaluate the specific needs dependent on seniority transplantation : 3 to 6 months, 6 months to 2 years, more than 2 years after transplantation. Secondary objectives :. ...
Tobias Deuse, M.D. is a cardiac and heart transplant surgeon internationally renowned for his pioneering work in the development of minimally-invasive techniques for mitral valve repair. Dr. Deuse graduated the University of Stuttgart (Germany) in 1994 with a BS in Physics, and in 2000 earned an M.D. from University of Wuerzburg. Dr. Deuse thereafter received advanced training in cardiothoracic surgery at the University Hospital Munich-Grosshadern and University Heart Center Hamburg-Eppendorf. After obtaining his board certification in Germany in 2007 as a heart surgeon, Dr. Deuse completed a surgical fellowship in Lung and Heart-Lung Transplantation at Stanford.. After returning to Germany in 2009, Dr. Deuse was appointed Director for Heart and Lung Transplantation at the University Heart Center in Hamburg. He achieved international acclaim for his development of innovative approaches to heart failure surgery, most notably minimally-invasive techniques for the implantation of ventricular assist ...
Previous studies have reported mortality rates of up to 56% associated with pregnancy in pulmonary arterial hypertension (PAH) but the management of this disease has changed considerably in recent years.. We compiled a multinational, prospective registry to examine the contemporary outcome of pregnancies in patients with PAH.. During a 3-yr period, the 13 participating centres reported 26 pregnancies. Three (12%) females died and one (4%) developed right heart failure requiring urgent heart-lung transplantation. There were eight abortions; two spontaneous and six induced. 16 (62%) pregnancies were successful, i.e. the females delivered healthy babies without complications. These females had well controlled PAH (pulmonary vascular resistance (PVR) 500±352 dyn·s·cm−5); eight of them were long-term responders to calcium channel blockers. In contrast, the females who died or required transplantation had poorly controlled PAH (PVR 1,667±209 dyn·s·cm−5).. Pregnancy remains associated with a ...
TY - JOUR. T1 - Airway obstruction after autologous reimplantation of the porcine lobe. AU - McGahren, E. D.. AU - Teague, W. G.. AU - Flanagan, T. L.. AU - White, B. J.. AU - Barone, G. W.. AU - Johnson, A. M.. AU - Kron, I. L.. PY - 1989/1/1. Y1 - 1989/1/1. N2 - Bronchiolitis obliterans (irreversible small airway obstruction) is a late complication of heart-lung transplantation. Chronic immune rejection is believed to be the major cause of this complication. Our hypothesis was that denervation might contribute to airway obstruction. To test this hypothesis in the absence of immune rejection, we performed a lobectomy of the upper lobe of the left lung and autologous reimplantation of the lower lobe of the left lung in 13 growing pigs. To serve as age-matched controls, six other pigs had sham left thoracotomy and nine others had a lobectomy of the upper lobe of the left lung alone. Nine to 10 weeks after operation, the animals were anesthetized and the lungs mechanically ventilated. The lobes ...
Fourteen sufferers who created B cell or lymphoproliferative lesions after kidney lymphomas, liver, heart, or heart-lung transplantation in Pittsburgh during 1981C1983 acquired active an infection with Epstein-Barr trojan (EBV) of the principal (six sufferers), reactivated (seven sufferers), or chronic (one individual) type. bottom line was reached in a listing of 5,550 transplant recipients getting cyclosporine [18]. Advancement of antibodies to EBV antigens in sufferers with tumors The antibody replies to EBV antigens from the 14 tumor sufferers before and after transplantation are summarized in desks 3 and ?and4.4. All 14 sufferers acquired serological proof active EBV an infection. Thirteen sufferers acquired goes up within their titers of antibody to EA or VCA, a selecting indicating principal or reactivated an infection (desk 3). One renal transplant individual (individual 14), a 52-year-old guy with polycystic kidneys, didnt show a growth in virtually any serological marker but acquired ...
Neonatal and pediatric heart surgery, pediatric and adult heart and heart-lung transplantation, complex valve repairs, mechanical cardiac assist devices, surgery for end-stage heart failure.. ...
Assistant Professor, VCU School of Medicine; Director of Heart Transplantation, Heart-Lung Transplantation and Mechanical Circulatory Support, VCU Health System ...
AGE DISTRIBUTION FOR DONORS OF PEDIATRIC HEART RECIPIENTS (Transplants: January June 2006) Number of Transplants ISHLT 2007 J Heart Lung Transplant 2007;26:
J Heart Lung Transplant 2009;28: AGE DISTRIBUTION FOR DONORS OF PEDIATRIC HEART RECIPIENTS (Transplants: January June 2008) ISHLT 2009
Chris Carlsten, MD MPH is an Associate Professor of Medicine, Canada Research Chair in Occupational and Environmental Lung Disease and holds the Astra-Zeneca Chair in Occupational and Environmental Lung Disease at the University of British Columbia. He is the Director of the Air Pollution Exposure Laboratory and also holds adjunct positions at the Peter Wall Institute for Advanced Studies, the UBC School of Population and Public Health and the Centre for Heart Lung Innovation (formerly James Hogg Research Centre).
Question - How much permanent damage have I done to my heart/lungs ?. Ask a Doctor about when and why Smoking cessation is advised, Ask a Cardiologist
The Cedars-Sinai Heart Institute has set a new standard for U.S. heart transplantation by completing 117 adult heart transplants and two adult heart-lung transplants, for a total of 119 adult heart transplants in a single year. The previous number set in 2005, was 98 adult heart transplants performed in one year.
When high blood pressure occurs in the pulmonary vessels surrounding the lungs, it causes shortness of breath, chest pain, dizziness, and other symptoms. This chronic medical condition can be inherited, associated with other diseases or conditions, or may be idiopathic, meaning its exact cause is unknown.. Medical therapy and surgery can help many patients with pulmonary hypertension, but as the disease progresses, catheter-based interventions may be used either to alleviate symptoms or to act as a "bridge" until the patient can receive a lung transplant or less commonly, a heart-lung transplant. One such procedure, called an atrial septostomy, involves using a balloon to widen the space between the right and left atriums of the heart to improve blood flow.. CRF is committed to advancing cardiovascular research and improving care for patients with heart disease. Using our vast experience and expertise, we are focused on developing technologies, therapies, and treatments for disease states such ...
Nineteen Fifty ushered in the first transplant of embryonic tissue. In 1956 the Glenn Procedure for tricuspid atresia was developed, another example of clinical research within the Department. Ten years later, the first Phrenic nerve pacemaker was used allowing quadriplegics to breath without a respirator. Clinical Translational Research thrived over the next 20 years. We established the first skin bank in New England. We performed the first heart-lung transplant in Connecticut, which would not have been possible without many long, dedicated research hours to prepare and plan and practice the procedure. In 1990 we became one of the first centers for the Cryoablation of hepatic tumors, just another example of translational research ...
When Claire Sylvia received a heart-lung transplant she believes she also inherited some of the personality of the donor. The ancient Egyptians, for whom the heart rather than the brain was the centre of being, may have found this idea plausible. But her doctors reckoned it was absurd-and anyone reading this memoir, A Change of …
Companies making vaccines to protect against biological agents or pandemic viruses would be shielded from lawsuits, even if they are negligent or reckless, under a provision inserted into a military spending bill by Senator Bill Frist of Tennessee, the majority leader. Reviving the nations flagging vaccine industry is a long-held goal of Mr. Frist, a heart-lung transplant surgeon who has made health care legislation the centerpiece of his Senate career. In a meeting with reporters Saturday night, Mr. Frist described the provision, which was added to the bill produced by a House-Senate conference committee, as one that offered drug makers targeted liability protection.
During follow up, cancer was diagnosed in 108 patients (42%). Statins reduced the risk of any cancer by 65% (p=0.0001). Eight years after transplantation the cumulative incidence of tumours was 34% in patients not receiving a statin compared to 13% in patients receiving a statin (p=0.003). The benefit persisted at the 10 year (39% vs. 18%) and 12 year follow-up (42% vs. 22%).. Statin use was associated with improved cancer free and overall survival (both p=0.0001). The beneficial effect of statins on preventing cancer and reducing death from all causes was independent of patients cholesterol levels. This suggests that the benefit of statins was due to their immunomodulatory effects.. Guidelines from the International Society for Heart & Lung Transplantation (ISHLT) recommend giving a statin to patients after heart transplantation to reduce graft atherosclerosis. This study shows that there are additional benefits to following that recommendation.. ...
Designed for quick and easy testing of patients, the Micro 1 is ideal for general practitioner and private doctors offices, outpatient hospital departments, occupational health settings, heart - lung transplantation units, and COPD patients where devices can be taken away by the patient for self testing and health surveillance management.. ...
We understand that living with a heart, lung or vessel disease or caring for someone with such a disease can be hard. But with the right information and support anyone can play an active role in managing their disease. Find out more. COPD Stands for Chronic Obstructive Pulmonary Disease which means patients find it difficult to breathe when doing daily tasks like climbing the stairs. Over 10% of Canadians over 40 years of age have COPD and there is no cure - but there are treatments and lifestyle choices that we are actively studying.
My first side effects from Remicade (after being on it for a while) were pounding, racing and irregular heartbeat. I also felt like I was getting hot and flushed. It was very scary. No nurses were around, so I just got through the experience and didnt say anything. The next time it happened but worse, and I said something. They didnt seem overly concerned. The following time, a nurse came in and asked me if I had experienced any side effects. I mentioned that heart thing and she said that that was a serious side effect and that they would not give me anymore of the Remicade at the infusion center. I had to get it at the hospital with close monitoring. Well, the first hospital one was fine. The next time I had the problems, but worse along with severe stomach pains, fever, and difficulty breathing. I had to stop Remicade. After that from time to time I would have heart racing. Then my heart got stuck racing so fast I could not count the beats per minute. I went to the ER and was told my heart ...
Last year, the SCOT-HEART trial (Scottish COmputed Tomography of the HEART) demonstrated that coronary computed tomography angiography (CCTA) markedly clarified diagnoses for patients with suspected angina due to coronary heart disease (Lancet 2015;385[9985]:2383-91). Whether CCTA-guided changes in diagnoses led to appropriate improvements in invasive coronary angiography and initiation of preventive treatments, and whether these changes could be attributable to an improvement in clinical outcome, were unanswered questions. Now, a sub-analysis of SCOT-HEART has provided answers that may change how coronary artery disease (CAD) is diagnosed and managed (J Am Coll Cardiol 2016;67:1759-68). ...
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We present a 20-year-old primiparous patient status post heart transplant at 6 months with long-standing hypertension progressing to super-imposed preeclampsia. Pregnancy and delivery after thoracic transplantation is no longer a rare occurrence, however, these women are at a greater risk of gestational hypertension and preeclampsia.1 Current literature does not provide treatment guidelines for treatment of hypertensive disorders in patients with a transplanted heart. In this case report, we explore the different treatments for maintaining blood pressures in the transplanted neurovascular system, effects of eclampsia prevention on blood pressure, and how fluctuations in blood pressure in a long-standing hypertensive can affect fetal heart tracings. A literature search was conducted using terms
... supplies organs, such as hearts, to those in need of an organ transplant. A heart transplant is a surgical procedure that replaces a failing heart with a healthy donor heart. Physicians make a midline incision and open the sternum to get to the heart.. The great vessels of the heart are attached to a heart-lung bypass machine to maintain blood flow to the body and brain. The unhealthy heart is removed and a healthy donor heart is then sutured into place. The heart-lung bypass machine is removed and the new heart is restarted.. Individuals can choose to donate their organs if they die. If youd like to donate your heart or other organs when you die, be sure to tell members of your family. In some states, you can state your wishes on the back of your drivers license. You may also contact an organ donation organization to ask for more information.. ...
Pulmonary hypertension (PH) is commonly encountered when managing the patient with an acute critical illness. The impact of PH on cardiac function can be devastating if it is not quickly recognized. The goal of this talk is to arm clinicians with some simple techniques to predict and assess for complications of PH, identify the resuscitation targets in a crashing patient with PH, and finally review some major pitfalls in the management of the patient with PH.. ...
HLT 314V Week 2 Discussion 1 & Discussion 2HLT 314V Week 2 Discussion 1Select one area of health policy and describe the impact that policy formation places
J Heart Lung Transplant. 2012 Aug;31(8):865-73. doi: 10.1016/j.healun.2012.04.008. Epub 2012 May 30. Research Support, N.I.H., Extramural
Heart - Aorta & Vessels ,Normal anatomy showing aorta and vessels. Also available with sutures as heart transplant, cuts on donor heart, and heart/lung transplant procedure.