Isaac Tea MD , Stephanie Fuentes Rojas MD , Varshni Nandakumar BS , Su-Min Chang MD , Ponraj Chinnadurai MBBS, MMST , James Young MD , Alan Lumsden MD , Arvind Bhimaraj MD, MPH
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CT-guided biopsy in heterotopic heart transplant: A case report
Background
Heterotopic heart transplantation is a surgical technique that has not been embraced broadly. In this historic technique, the donor heart is sutured in parallel to the recipient heart with both hearts in place.
Case summary
We report a patient who received a heterotopic heart transplant at our institution more than 15 years ago with preserved cardiac function and who needed a myocardial biopsy due to heart failure symptoms. Due to complex anatomy, a cardiac computed tomography imaging reconstruction was used to create a live roadmap overlay on fluoroscopy during myocardial biopsy. Such a technique facilitated obtaining a biopsy successfully and safely to rule out rejection.
Discussion
Heterotopic heart transplantation is a surgical procedure that has a potential physiologic and immunologic advantage in select patients needing a heart transplant. Utilizing imaging guidance for navigating complex anatomy to perform a myocardial biopsy can have potential applications in providing safe and increasing yield in patchy diseases of the heart.
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