Heterotopic heart transplant with arrhythmic heart rate of 45 – 125 bpm

Shu-Hsun Chu, M.D. Cardiovascular Center
Far Eastern Memorial Hospital, Taipei, Taiwan
 |  2006-11-27

History

A-52-year-old man suffered form dyspnea on exertion and chest tightness for 2 years. Because progressive symptoms failed to respond to medical treatment, the patient was admitted for heart transplantation evaluation. On April 2001, a 48 year old head injury donor with good cardiac function passed the brain-death examination. During transport of the donor to the Far Eastern Memorial Hospital, cardiac arrest occurred. Cardiopulmonary resuscitation was performed immediately in the ambulance. When the donor arrived at the hospital, his blood pressure was 60/30 mm Hg, and heart rate 36 bpm. An immediate sternotomy revealed that the heart was already arrested, distended and cyanotic. The donor was soon put on cardio-pulmonary bypass. After that, the heart started to beat again and could maintain a stable hemodynamic status even when CPB was weaned off. Since the suitability of the resuscitated heart as orthotopic heart transplant was unclear, the hospital decided to do a heterotopic heart transplantation. 5 years after successful surgery the patient is in good condition.

 

Comments and Diagnosis
Comments and Diagnosis
The LAD was successfully reinserted onto the aorta. A gore tex graft with 6 mm in diameter was in between aorta and LAD.Both hearts are functional, but show different heart rates and rhythms. SOMATOM Definition’s high temporal resolution of 83 msec in combination with reliable ECG-editing functionality was of crucial importance in order to obtain diagnostic images of the rapidly changing heart rates between 45 and 125 bpm.

 

Examination Protocol

 

Scanner SOMATOM Definition
Scan area Aortic arch to diaphragm
Scan length 205 mm
Scan time 16.3 sec
Scan direction Cranio-caudal
Heart rate Arrhythmic 45-125 bpm
kV 120 kV
mAs 400 mAs/rot
Rotation time 0.33 sec
Temporal resolution Heart rate independent 83 msec
Slice collimation 0.6 mm
Slice width 0.75 mm
Pitch 0.22
Reconstruction increment 0.4 mm
Kernel B26

Footnotes

1. Chiu KM, Lin TY, Chu SH. Successful Heterotopic Heart Transplantation after Cardiopulmonary Bypass Rescue of Arrested Donor Heart. Transplantation Proceedings 2006;38:1514-1515.

2. Chiu KM, Lin TY, Li SJ, Chan CY, Chu SH. Hybrid Pulmonary Artery Conduit Angioplasty for Heterotopic Heart Transplantation. Transplantation Proceedings 2006;38:1538-1540.