2023 Volume 27 Issue 1 Pages 43-47
In heart transplantation, donation of hearts from older donors may lead to coronary artery disease. We present the case of a 32-year-old man with dilated cardiomyopathy who underwent heart transplantation from a 50-year-old donor who was certified brain dead. Coronary angiography conducted 4 weeks after the heart transplantation revealed three-vessel coronary artery disease, for which the patient underwent off-pump coronary artery bypass surgery a week later. Following intraoperative noradrenaline administration and dose up-titration for hypotension due to exposing and stabilizing coronary targets, the patient developed tachycardia (heart rate 126 beats/min), which improved after switching to continuous phenylephrine administration, and the patient became hemodynamically stable. The transplanted heart is denervated and shows atypical responses to medications. Although this patient experienced marked tachycardia, possibly due to intraoperative noradrenaline administration, the off-pump procedure was completed with adjusting medications without on-pump conversion.
