Aortic Valve Replacement and Tricuspid Valve Repair Five Years After Orthotopic Heart Transplantation in an Adult Patient

Abstract

In the current era of improved survival after orthotopic heart transplantation, post-transplant valve dysfunction is not an uncommon occurrence. The first treatment is medical management, but when it fails, surgery, possibly as retransplantation, may be needed. However, due to the scarcity of donor hearts, efforts are being made on the preservation of the cardiac allograft function by conventional operations in lieu of retransplantation. In this case report, we present a patient developing severe aortic valve insufficiency and moderate-to-severe functional tricuspid valve insufficiency five years after cardiac transplant, leading to progressive clinical deterioration and heart failure symptoms. The aortic valve was replaced with an Edwards Inspiris Resilia Nr. 23 biological prosthesis, and the tricuspid valve was repaired with a Medtronic Contour 3D Nr. 28 annuloplasty. The postoperative course was uneventful, and the patient remained well six months after her reintervention. In the literature, cases of patients undergoing valve operations following their heart transplants have already been described. However, to the best of our knowledge, this is the first case report describing a concomitant procedure of aortic valve replacement and tricuspid valve repair in an adult patient occurring five years after her cardiac transplant.