Transcatheter aortic valve implantation in an orthotopic heart transplant recipient with bicuspid aortic valve

Akleh, Subhi I.; Bandali, Alykhan; Edwards, Richard

doi:10.1002/ccr3.1845

Cited by 4 publications

(15 citation statements)

References 18 publications

(12 reference statements)

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“…[ 31 , 38 ] Bicuspid aortic valve is the most common congenital valvular abnormality in which only two cusps of the aortic valve are present since the separation of valve cusps does not happen in the fetal period. [ 7 , 31 ] Not only can this condition be defined at any age without any clinical findings but it also has a potential to cause stenosis and regurgitation in the aortic valve. [ 39 ] Although the appropriate treatment for transplant patients with bicuspid aortic valve is not clearly identified, this review found two different approaches in two different patients.…”

Section: Discussionmentioning

confidence: 99%

“…While the first patient with bicuspid aortic valve received aortic valve replacement, the second patient underwent transcatheter aortic valve implantation (TAVI). [ 31 , 38 ] Additionally, there is limited data on the outcomes of TAVI in patients having bicuspid aortic valve; thus, there is no standard treatment that has been established for this condition and its associated valve dysfunction. [ 38 ]…”

Section: Discussionmentioning

confidence: 99%

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Management options of valvular heart diseases after heart transplantation: A scoping review

Yilmaz,

Keenan

2024

Turk Gogus Kalp Dama

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Background: This study aimed to outline the valvular changes following heart transplantation and describe the management options to address these conditions. Methods: A literature search using EMBASE, MEDLINE, and PubMed databases was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines in this study. Clinical studies involving patients who had their first heart transplant and articles that mentioned management for valvular heart disease were included. Treatment options were grouped into four categories: cardiac surgery other than retransplant and valve surgery, valve replacement and repairs, nonsurgical interventions, and conservative management. Results: Nine hundred and three (6.56%) patients out of 13,757 patients (10,529 males, 3,228 females; mean age: 60.3±10.4 years; range, 20 to 83 years) undergoing heart transplantation were identified with valvular disease affecting one or more valves. The mean interval between the transplant and the diagnosis of valve disease was 11.31±6.95 years. The most common valvular heart disease was tricuspid regurgitation, with 796 (94.09%) occurrences, followed by mitral regurgitation (n=22, 2.6%), aortic regurgitation (n=14, 1.65%), aortic stenosis (n=11, 1.3%), and mitral stenosis (n=3, 0.35%). Additionally, the number of surgical valve replacement and repairs (n=89) was higher than nonsurgical interventions (n=20). Conclusion: Acquired valvular heart diseases after cardiac transplantation are an infrequent clinical presentation that can cause valvular changes in the recipient. According to the extracted data, there is no sole superior management option, and more research is needed in this area.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Management options of valvular heart diseases after heart transplantation: A scoping review

Yilmaz,

Keenan

2024

Turk Gogus Kalp Dama

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“…Current adult transplant guidelines recommend consideration of donor hearts with functionally normal bicuspid aortic valves with a Class I recommendation 17 . Most of the adult transplant literature reporting the usage of donor hearts with bicuspid aortic valves comes from single case reports describing “bench” aortic valve replacement at time of transplant or catheter‐based valve replacement after valve failure 8‐16 . Peri‐transplant aortic valve replacement is appealing in adults due to the excellent exposure afforded to the surgeon.…”

Section: Discussionmentioning

confidence: 99%

“…17 Most of the adult transplant literature reporting the usage of donor hearts with bicuspid aortic valves comes from single case reports describing "bench" aortic valve replacement at time of transplant or catheter-based valve replacement after valve failure. [8][9][10][11][12][13][14][15][16] Peri-transplant aortic valve replacement is appealing in adults due to the excellent exposure afforded to the surgeon. In the pediatric population, it is a much less attractive choice due to the limited options for aortic valve prostheses in smaller patients, as well as concerns over the longevity of aortic valve replacements considering the increasing survival of pediatric heart transplant recipients.…”

Section: Discussionmentioning

confidence: 99%

“…In order to increase utilization of hearts within this small pool, there has been a growing interest in transplanting "marginal" hearts in both pediatric and adult practice. There are case reports describing, [6][7][8][9][10][11][12][13][14][15][16] and even guidelines recommending, 17,18 the usage of grafts with bicuspid aortic valves in the adult transplant literature. To date, heart transplantation involving a donor heart with a bicuspid aortic valve has not been described in the pediatric transplant literature.…”

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confidence: 99%

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Outcomes following use of pediatric and young adult donor hearts with bicuspid aortic valves: A single‐center case series

Day

Hope

Puri

et al. 2021

Pediatric Transplantation

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Background Valvular disease in pediatric and young adult donor hearts may be a relative contraindication to graft use. Outcomes following the use of donor hearts with bicuspid aortic valve (BAV) have not been previously reported in children. We describe 4 cases of pediatric heart transplantation (HTx) utilizing a donor heart with a BAV. Case series Of the 469 HTx included in this study, 4 utilized a donor heart with a BAV. All recipients were female; median age was 11 years (range 0.3 to 19 years). In all cases, the BAV was not discovered until after HTx. All donors were less than 30 years old. The patients were followed for a median of 6 years (range 2 to 9 years) with all patients alive at last follow‐up. Two patients have transitioned to adult care, and 2 patients continue to follow in our clinic. In follow‐up, no patient has required an aortic valve intervention or had infective endocarditis. At last review, no patient had greater than mild aortic insufficiency or more than mild aortic stenosis. Three patients developed mild‐to‐moderate left ventricular hypertrophy in the first year post‐transplant that improved over time. One patient experienced a peri‐operative embolic stroke at time of transplant unrelated to the BAV. Conclusion On short‐ and intermediate‐term follow‐up, pediatric and young adult donor hearts with BAV demonstrated acceptable graft longevity and valvular function. A functionally normal BAV in a pediatric heart transplant donor should not be a contraindication to organ acceptance.

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Structural heart transcatheter interventions in orthotopic cardiac transplant and left ventricular assist devices recipients: A nationwide study

Blasco-Turrión,

Crespo-Leiro,

Donoso Trenado

et al. 2024

International Journal of Cardiology

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Transcatheter aortic valve implantation in an orthotopic heart transplant recipient with bicuspid aortic valve

Cited by 4 publications

References 18 publications

Management options of valvular heart diseases after heart transplantation: A scoping review

Management options of valvular heart diseases after heart transplantation: A scoping review

Outcomes following use of pediatric and young adult donor hearts with bicuspid aortic valves: A single‐center case series

Structural heart transcatheter interventions in orthotopic cardiac transplant and left ventricular assist devices recipients: A nationwide study

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