Doctor doing heart transplant realizes the donor heart is too small to fit. His solution—it’s crazy

"It is once-in-a-lifetime procedure a doctor performs."
February 15, 2018 10:29 am Last Updated: March 16, 2018 3:35 pm

Who doesn’t like a bargain? You go somewhere expecting one thing, and you return home with more than you thought you were going to get.

Of course, this mostly applies to shopping. When it comes to modern medicine, patients want to know exactly what is going to happen before a surgeon cuts them open.

Unfortunately that isn’t always possible. Doctors are subject to a number of variables that can force them to improvise on the fly.

Dr. A. Gopala Krishna Gokhale, a surgeon at Apollo Hospital in India, was presented with an unexpected problem while preparing to perform a heart transplant.

The heart Dr. A. Gopala Krishna Gokhale intended to use for transplant into a 56-year-old man was too small.

Posted by Dr Alla Gopala Krishna Gokhale on Tuesday, April 25, 2017

“The donor heart was of normal fist-size. The recipient’s heart was the size of a small football,” the surgeon said to The Hindu.

Time was running out. The man who was supposed to receive the transplant was beginning to experience other health related complications as a result of his heart failure.

Gokhale was familiar with a procedure that would be capable of utilizing the available heart and saving the man’s life. But it was risky and rarely performed.

It’s colloquially known as a “piggyback transplant,” and it sounds like something straight out of a science-fiction movie.

A heterotopic transplant, or “piggyback transplant,” is when the donor heart is transplanted alongside the native heart.

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There have only been about 150 heterotopic transplants ever performed. But with no time to spare, Dr. Gokhale had no other option.

A donor heart must be restarted within four hours of stopping. Considering factors like transport, prep, and surgery, that doesn’t leave much time for pondering.

The clock started at 6:50 am that morning, when the donor was officially pronounced deceased. It took two hours to reach Apollo Hospital, arriving at 8:50 am, where the transplant would take place.

Doctors at the hospital were waiting, ready to begin surgery right away.

In total, the surgery lasted a total of seven hours. It was a success, and the patient is expected to recover.

Posted by Dr Alla Gopala Krishna Gokhale on Tuesday, June 14, 2016

Dr. Gokhale was able to fit the second heart between the right lung and the original heart. Each heart serves a different purpose, and they beat at different tempos.

As a result, the patient will now have two different pulses and a complex ECG pattern.

“Two hearts in the patient complement each other to facilitate circulation, but beat at different rates,” Gokhale said.

“It is once-in-a-lifetime procedure a doctor performs.”

To watch the surgery, click here. (Warning: viewer discretion advised)