After undergoing a pioneering operation, a 45-year-old Keralite is the first person in India to live with two beating hearts, one of them from a woman.

According to reports, the man underwent the transplant, the first of its kind in India, as he was suffering from heart failure. But instead of replacing his old heart with a new one, doctors connected a new heart to the old one so they can share the workload.

The surgeons at Kovai Medical Centre and Hospital said a normal transplant would not work because his heart was functioning at only 10% and his lung pressure and resistance were extremely high.

The Times of India reported that the doctors chose to perform a heterotopic transplant, fixing an artificial heart on the left and right side, allowing the failing heart to “piggyback” on an efficient new heart. “When a brain dead woman of almost the same age and his size came in on Monday, we found a heart that matched his heart’s size and chose to try the third option, which is called a heterotopic transplant,” Dr Prashant Vaijyanath was quoted as saying.

During the three-and-a-half-hour surgery, the surgeons first opened the patient’s chest cavity and created a small space for the heart in his right side, because the normal heart always lies on the left side. The entire surgery was performed without stopping the native heart.