**5. Heterotopic heart transplant**

This chapter mainly focuses on orthotopic heart transplantation (the standard explant of the old diseased heart, and implant of a new donor heart into the chest cavity). However, there is another form of heart transplant which has been performed since the 1970's called heterotopic heart transplantation [7]. While this is rare, there are few select indications for this procedure, and we wanted to include this for completion.

An extra length of aorta is required, and the pulmonary veins must be transected close to their origin to give the recipient surgeon enough room to operate with. The procuring surgeon must also take as much of the SVC/IVC as possible. The Pulmonary Artery will need to be augmented with a graft material in the recipient

because the implanting surgeon will connect the pulmonary artery of the new heart to the pulmonary artery of the recipient's native heart. Therefore, it becomes extra important to take as much of the pre-bifurcation PA as possible.
