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An Indian man recently underwent a life-saving heart transplant and was left with two beating hearts after the procedure. This might sound bizarre to some, but the procedure — piggyback transplant — is not new.

The rare procedure, which is also known as a heterotopic heart transplant, was developed and first performed by South African cardiac surgeon Dr Christiaan Barnard.

The most common heart transplant or a cardiac transplant procedure performed on patients with end-stage heart failure or severe coronary artery disease is known as the orthotopic procedure. In this process, the patient's own heart is removed and replaced with the donor's heart.

In another procedure known as the heterotopic transplant, or piggyback transplant, the patient's diseased heart is left in place while the donor's heart is added — giving the person two hearts. The first such heterotopic heart transplant was performed by Barnard in 1974.

In the recent case, however, doctors didn't plan to do a piggyback transplant on the 56-year-old patient who was suffering from end-stage heart failure. He was admitted to Apollo hospital in Hyderabad and was rushed to the operation theatre for the transplant.

However, a few minutes before the life-saving transplant, surgeons discovered that the donated organ from 12-year-old Mekala Kumar was too small, according to reports published in The Hindu.

Surgeon Dr Gopala Gokhale was therefore forced to try a radical procedure to save the elderly man. Gokhale revealed that the patient's lung blood pressure shot up to four times the normal level. In such emergency, he inserted the donor's heart which he said was the size of a "small football", alongside the existing one to fix the issue.

The team had to cut away part of the pericardium and fix the new heart between it and the lung, as part of the procedure that took place for seven hours.

"Two hearts in the patient complement each other to facilitate circulation but beat at different rates. It is a once-in-a-lifetime procedure a doctor performs. Patient's blood pressures are close to normal and he is stable. But there will be other issues in future," Gokhale said.