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Figure. A 53-year-old woman with dilated myocardiopathy underwent cardiac transplantation in June 1988. Due to severe pulmonary hypertension (systolic pulmonary artery pressure 88 mm Hg, Wood units 5.8), a heterotopic heart transplant was performed. During the postoperative period, contraction of both hearts was seen in the electrocardiogram (top) with a positive deflection of the donor heart and a negative of the native heart. When both hearts contracted simultaneously, as seen at the left part of the tracing, the blood pressure curve (bottom) had a normal, monophasic configuration. However, different heart rates led to asynchronous contractions, as seen at right, producing a biphasic pulse wave similar to the one found in counterpulsation.
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