Two Hearts, Believing in Just One Mind: What Is the Rhythm?

Abstract

A 59-year-old patient who underwent orthotropic heart transplantation for end-stage nonischemic cardiomyopathy presented 2 months later with palpitations and fatigue. He had a history of hypertension, diabetes mellitus, and well-controlled HIV. Of note, pretransplant imaging had demonstrated a persistent left-sided superior vena cava draining into a large coronary sinus. Therefore, a biatrial anastomosis surgical technique (involving suturing the donor right atrium to a portion of the native right atrium with preservation of the native and donor coronary sinuses) was used at the time of transplantation.