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A method of heterotopic cardiac transplantation has been developed which is performed through a left thoracotomy and requires only two vascular anastomoses. Systemic heparinization and cardiopulmonary bypass are not necessary. Preliminary experiments demonstrated that this heterotopic transplant technique was effective for left ventricular assist; in some experiments, a multimode atrioventricular programmable pacemaker was used to provide sequential pacing for "counterpulsation." This technique or similar techniques may have potential clinical benefit for patients with intractable left ventricular failure.
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