Erythropoietic protoporphyria (EPP) is a disorder of heme synthesis that causes excessive accumulation of protoporphyrin. The predominant clinical feature is photosensitivity triggered by light at wavelengths near 400 nm. We describe a 52-year-old man wit

Severely elevated pulmonary vascular resistance (PVR) is a relative contraindication to orthotopic heart transplantation. A potential novel strategy to reverse elevated PVR may be implantation of a chronic left ventricular assist device with subsequent left ventricular unloading. We present a patient with elevated PVR secondary to congenital heart disease who was listed for heart-lung transplant. The patient underwent placement of biventricular assist devices and subsequently experienced marked reduction of PVR, ultimately enabling successful heart transplantation.