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...

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Main Authors: 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
Format: Article
Language:English
Published: Elsevier 2025-05-01
Series:JHLT Open
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Online Access:http://www.sciencedirect.com/science/article/pii/S2950133425000540
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author 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
author_facet 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
author_sort Isaac Tea, MD
collection DOAJ
description 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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spelling doaj-art-1fc7ecbf5cea4728a2d53618e4d6bba82025-08-20T02:28:22ZengElsevierJHLT Open2950-13342025-05-01810025910.1016/j.jhlto.2025.100259CT-guided biopsy in heterotopic heart transplant: A case reportIsaac Tea, MD0Stephanie Fuentes Rojas, MD1Varshni Nandakumar, BS2Su-Min Chang, MD3Ponraj Chinnadurai, MBBS, MMST4James Young, MD5Alan Lumsden, MD6Arvind Bhimaraj, MD, MPH7Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston, TexasDepartment of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston, TexasSchool of Engineering Medicine, Texas A&M University, Houston, TexasDepartment of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston, TexasDepartment of Vascular Surgery, Houston Methodist DeBakey Heart and Vascular Center, Houston, TexasDepartment of Cardiology, Cleveland Clinic Foundation, Cleveland, OhioDepartment of Vascular Surgery, Houston Methodist DeBakey Heart and Vascular Center, Houston, TexasDepartment of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas; Corresponding author: Arvind Bhimaraj, MD, MPH, 6550 Fannin St Suite 1801 Smith Tower, Houston, TX 77030. Telephone: 713-441-110. Fax: 713-793-7032.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.http://www.sciencedirect.com/science/article/pii/S2950133425000540imaging guidanceendomyocardial biopsyheterotopic heart transplantCT fusion3D anatomy
spellingShingle 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
CT-guided biopsy in heterotopic heart transplant: A case report
JHLT Open
imaging guidance
endomyocardial biopsy
heterotopic heart transplant
CT fusion
3D anatomy
title CT-guided biopsy in heterotopic heart transplant: A case report
title_full CT-guided biopsy in heterotopic heart transplant: A case report
title_fullStr CT-guided biopsy in heterotopic heart transplant: A case report
title_full_unstemmed CT-guided biopsy in heterotopic heart transplant: A case report
title_short CT-guided biopsy in heterotopic heart transplant: A case report
title_sort ct guided biopsy in heterotopic heart transplant a case report
topic imaging guidance
endomyocardial biopsy
heterotopic heart transplant
CT fusion
3D anatomy
url http://www.sciencedirect.com/science/article/pii/S2950133425000540
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