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Two Hearts Are Better Than One

Hannah Copeland, MD
University of California San Diego

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hannah copeland"Two hearts are better than one," on St Valentine's Day. But now that we've reached St Patrick's Day, can we still subscribe to that romantic idea? A patient well known to us received a heterotopic heart just over a year ago here in San Diego. The media was fascinated and he became famous for a few days. No one remembers him now, but he is still around and doing very well thanks to his piggy back heart. Donated from an athlete, it was implanted as a "biologic LVAD", left atrium to left atrium, aorta to aorta, superior vena cava to superior vena cava and donor pulmonary artery to recipient right atrium. The patient's pre-operative pulmonary artery pressure was 80-90 mm Hg systolic, the trans-pulmonary gradient and pulmonary vascular resistance were high. For financial reasons, an LVAD was not an option.

The patient was 43 years-old at the time of transplant with a good right ventricle and no signs of high right sided filling pressures. His left ventricle had a pressure of 90 mm Hg with severe systolic failure on maximal medical therapy and IV milrinone. Rather than an LVAD bridge to transplant with the morbidity and mortality as well as cost of 2 operations, he had just one operation.

Perhaps we should reconsider the heterotopic heart transplant as an option. Two hearts have served him well since Valentine's Day a year ago. He is fully active -living proof that he should not be forgotten. He has something great to celebrate this St. Patrick's Day. We should all raise a green beer to him!

Disclosure Statement:
The author has no conflicts of interest to disclose.