Linked pacing after heterotopic heart transplantation with concurrent leftventricular reduction of the native heart

A 30-year-old man with dilated cardiomyopathy underwent heterotopic heart t ransplantation, concurrently with surgical reduction of the native left ven tricle, a mitral valvuloplasty, and an apical thrombectomy. Postoperatively , the patient had hemodynamic instability that was refractory to convention al medical therapy. Temporary sequential pacing of the 2 hearts was used to induce timed counterpulsation, which resulted in marked hemodynamic ir;imp rovement. To the best of our knowledge, this case involves the 1st report i n the English-language literature of clinical usage of paced, linked counte rpulsation to treat acute hemodynamic compromise early after heterotopic he art transplantation.