Aorta-to-left-atrial shunting through a previously performed heterotopic heart transplant: an unusual complication of orthotopic re-transplantation.

Heterotopic heart transplantation is rarely performed today, except in cases of recipient-donor size mismatch and when addressing complications associated with recipient pulmonary artery hypertension. As in orthotopic cardiac transplantation, occurrence of allograft vasculopathy occasionally calls for re-transplantation. Although orthotopic re-transplantation without removal of the heterotopic allograft has been described previously, we report the case of a patient who presented with an unusual complication.