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The Annals of Thoracic Surgery, Vol 51, 987-991, Copyright © 1991 by The Society of Thoracic Surgeons

ARTICLES

Heterotopic heart transplantation and native heart ventricular arrhythmias

C Kotliar, FW Smart, ME Sekela, A Pacifico, CM Pratt, GP Noon, ME DeBakey and JB Young
Department of Surgery, Methodist Hospital, Houston, Texas.

Heterotopic heart transplantation has been said to be contraindicated in patients with serious native heart arrhythmias that produce hemodynamic instability. Placement of heterotopic allografts, however, can theoretically act as a biological biventricular assist device to provide hemodynamic support during these unstable rhythms. Further, this operation might beneficially alter the hemodynamic milieu of heart failure such that the arrhythmias are ameliorated. Described is our experience with 4 patients with heart failure receiving heterotopic cardiac allografts, documenting changes in native heart arrhythmia that occurred. These cases demonstrate that heterotopic grafts can adequately sustain hemodynamics during malignant native heart dysrhythmia. We believe native heart ventricular arrhythmias are not a contraindication to heterotopic heart transplantation.

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