The video shows an orthotopic heart transplantation using the “bicaval technique”. It begins with the harvesting of the donor heart (frequently at a remote site, as in the video). Another surgeon stays with the patient to prepare him for the transplant (opening the chest and installation of cardiopulmonary bypass). Coordination between the two surgical teams (logistics, transportation, anesthesia and incision) must be perfect in order to minimize the duration of ischemia (time between removal and implantation of the heart must remain under 5 hours). Everything must be ready at the arrival of the donor heart, so that the surgeon can perform the transplant without wasting time. The graft is prepared (to fit with the recipient) and the cardiopulmonary bypass started allowing the explantation of the failing heart. The different stages of the intervention are shown interspersed with diagrams. At the end of vascular anastomoses, the heart is purged to remove any air bubbles, then the aorta unclamped. The heart is defibrillated with an electric shock.