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Total Artificial Heart Salvage of a Heterotopic Heart Transplant Patient

Gregoric, Igor D.*; Akay, Mehmet H.*; Salas de Armas, Ismael A.*; Patel, Manish K.*; Nathan, Sriram S.*; Akkanti, Bindu*; Stojanovic, Stevan; Radovancevic, Rajko*; Kar, Biswajit*

doi: 10.1097/MAT.0000000000000962
Case Report: PDF Only

Rescuing heterotopic heart transplantation (HHT) patients remains a challenge in the field. When a 41 year old patient was transferred to our service, we chose a novel approach that is reported herein. The HHT had been performed over 20 years ago, and in 2016, because of complications, the patient was listed for transplant with a 1A status. For the first time, the SynCardia 50cc total artificial heart (TAH) (SynCardia Systems, LLC, Tucson, AZ) was used in an HHT patient. Investigators attained approval to use the SynCardia 50cc investigational device, as this was an emergent case with few options. The donor heart from the HHT was left in place, alongside the TAH. By leaving the donor heart from the HHT, the need for long and tedious extensive dissection around the right lung was eliminated; thereby reducing the potential risk of lung parenchymal injury, massive bleeding, and complex air leaks. The procedure was successful, and the patient underwent a successful orthotopic heart transplantation 6 months after being placed on TAH.

From the *Center for Advanced Heart Failure, University of Texas Health Science Center at Houston/Memorial Hermann Hospital – Texas Medical Center, Houston, Texas

Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.

Submitted for consideration May 2018; accepted for publication in revised form January 2019.

Disclosure: The authors have no conflicts of interest to report.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML and PDF versions of this article on the journal’s Web site (

Correspondence: Igor D. Gregoric, 6400 Fannin St., Suite 2350 Houston, TX 77030. E-mail:

Copyright © 2019 by the American Society for Artificial Internal Organs