Aortic valve replacement with bioprostheses in liver transplant recipients

Three cases of aortic valve replacement with porcine bioprostheses are reported in liver transplant recipients at two to six years after transplantation. Indications for aortic valve replacement (AVR) were aortic stenosis (n = 2) and aortic regurgitation (n = 1). The use of bioprostheses was recommended because of patient age, the need for multiple liver biopsies, and contraindication to the use of anticoagulation therapy. The patient who underwent AVR because of aortic regurgitation developed structural valve deterioration (SVD) during the next five years after surgery, and thus replacement of the bioprosthetic valve was required. Recipients of liver transplant who undergo valve replacement with tissue valves should be carefully followed up because of the risk of early SVD. AVR may be performed safely after liver transplantation.