LAUSR

Introduction In heterotopic heart transplantation (HHTx), the donor heart is connected to the recipient heart in a parallel fashion, acting as a biological biventricular assist device. This technique has been developed before the cyclosporine era to reduce early postoperative death related to graft failure. HHTx is associated with a lower long-term survival compared with orthotopic heart transplantation and is now only used for selected patients with high pulmonary vascular resistance as an alternative to heart-lung transplantation or in case of major donor-to-recipient size mismatch. HHTx survivors are exposed to a risk of ventricular arrhythmias (VAs) originating from the native heart. Only scarce literature exists regarding their management, which is crucial to prevent hemodynamic compromise and thrombus formation. Here, we report a case of successful recipient ventricular tachycardia (VT) catheter ablation and we discuss the clinical challenges that arise from the particular setting of HHTx.