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A 41-year-old man with acute-on-chronic decompensated heart failure presented for evaluation for heart transplantation. He had non-ischaemic cardiomyopathy and had undergone a heterotopic heart transplantation (HHT) 24 years earlier. His severe pulmonary hypertension necessitated a heterotopic transplant, with the native heart maintaining the right circulation while the donor heart worked as a biologic left ventricular assist device. His ECG showed two QRS …
Contributors AM and KAT provided care for the patient. All authors wrote and revised the report and approved the final version.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.