Abstract: Objective: To sum up the experience of intraoperative management of orthotopic cardiac thransplantation.Methods: 3 recipients suffered from terminal myocardiosis.The transplantive operation was performed with inferior and superior vena anastomotic technique.During perioperative period,we selected and maintained the recipients,protected donor isolated heart,supported circulation,decreased immunitive reaction,controlled infections.Results: 3 patients survived and discharged uneventfully,heart function improved from NYHA class Ⅳ preoperatively to NYHA classⅠⅡ.Conclusion: Suitable recipient,proper donor heart procurement and preservation,suitable maintenance of circulation,proper managements of anti-immunitive reaction,prevention of infections are critical for successful heart transplatation.