Partial Heart Transplantation in Adult Cardiac Surgery

Abstract

Many young adults require heart valve replacements. Current options for valve replacement in adults include mechanical valves, bioprosthetic valves, or the Ross procedure. Of these, mechanical and bioprosthetic valves are the most common options, although mechanical valve usage predominates in younger adults due to durability, while bioprosthetic valve usage predominates in older adults. Partial heart transplantation is a new method of valvular replacement that can deliver durable and self-repairing valves and allow adult patients freedom from anticoagulation therapy. This procedure involves transplantation of donor heart valves only, permitting expanded utilization of donor hearts as compared with orthotopic heart transplantation. In this review, we discuss the potential benefits of this procedure in adults who elect against the anticoagulation regimen required of mechanical valve replacements, although it has not yet been clinically established. Partial heart transplantation is a promising new therapy for the treatment of pediatric valvular dysfunction. This is a novel technique in the adult population with potential utility for valve replacement in young patients for whom anticoagulation therapy is problematic, such as women who wish to become pregnant, patients with bleeding disorders, and patients with active lifestyles.

Partial heart transplantation: Growing heart valve implants for children

“…Partial heart transplants are the only heart valve implants that can fulfill all biological functions of native heart valves, including growth and self‐repair. This application for partial heart transplantation is particularly suitable for neonates and infants, but it also has selected indications for patients through adulthood 87 . Moreover, partial heart transplantation of the ventriculoarterial outflow valves is a prototype for other growing implants delivered through transplantation.…”

“…This application for partial heart transplantation is particularly suitable for neonates and infants, but it also has selected indications for patients through adulthood. 87 Moreover, partial heart transplantation of the ventriculoarterial outflow valves is a prototype for other growing implants delivered through transplantation. This strategy offers qualitatively new treatment options.…”