First of all, we must emphasize that our method proposal is not, strictly speaking, a heterotopic heart transplantation, instead, the donor’s heart is set in heterotopic position aiming reduction of pulmonary vascular resistance so that, in an opportune time, when pulmonary pressure decreases, a second and final surgery is performed making a “twist”, as we will place the donor’s heart on orthotopic position. Besides that, continuous dilation of the myocardium provides a favorable site for endocarditis. ...your concern about clinical indication and clinical practice of our proposal method, we briefly explain that it is the point of our research, and two hearts are two organs to control, which one is healthy and the other, even with regression of pulmonary pressure, is still an organ that suffered with pulmonary hypertension and its disfunction could be catastrophic.