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Michael E. Sekela
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Ann Thorac Surg 1991;51:987-991
© 1991 The Society of Thoracic Surgeons


Articles

Heterotopic heart transplantation and native heart ventricular arrhythmias

Carol Kotliar, MD, Frank W. Smart, MD, Michael E. Sekela, MD, Antonio Pacifico, MD, Craig M. Pratt, MD, George P. Noon, MD, Michael E. DeBakey, MD, James B. Young, MD*

Department of Surgery and the Multi Organ Transplant Center, The Methodist Hospital and Baylor College of Medicine, Houston, Texas, USA

Accepted for publication February 15, 1991.

* Address reprints requests to Dr Young, 6565 Fannin SM 491, Houston, TX 77030.

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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