Alejandro Aris, MD, PhD  The Annals of Thoracic Surgery 

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Biphasic pulse wave due to asyncronous heart contractions in heterotopic cardiac transplantation  Alejandro Aris, MD, PhD  The Annals of Thoracic Surgery  Volume 68, Issue 5, (November 1999) DOI: 10.1016/S0003-4975(99)00748-1

Figure A 53-year-old woman with dilated myocardiopathy underwent cardiac transplantation in June 1988. Due to severe pulmonary hypertension (systolic pulmonary artery pressure 88 mm Hg, Wood units 5.8), a heterotopic heart transplant was performed. During the postoperative period, contraction of both hearts was seen in the electrocardiogram (top) with a positive deflection of the donor heart and a negative of the native heart. When both hearts contracted simultaneously, as seen at the left part of the tracing, the blood pressure curve (bottom) had a normal, monophasic configuration. However, different heart rates led to asynchronous contractions, as seen at right, producing a biphasic pulse wave similar to the one found in counterpulsation. The Annals of Thoracic Surgery 1999 68, DOI: (10.1016/S0003-4975(99)00748-1)