Heterotopic heart transplantation is still indicated in selected patients mainly with pulmonary vascular bed problems. Cardio-pulmonary bypass (CPB) has well known deleterious effects on the pulmonary vascular bed due to leukocyte sequestration as well as on the immune response of the patients. Also the negative effects of the cardioplegia on the native heart is another drawback of the classical heterotopic heart transplantation with the use of CPB. We want to present our new implantation technique for heterotopic heart transplantation without CPB, used successfully in our institution at the Kocaeli University on a patient with resistant pulmonary hypertension and dilated cardiomyopathy.