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Updated: Jun 27, 2026
Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
Published on: May 21, 2017
Aortic valve replacement for aortic stenosis during orthotopic cardiac transplant
Marco E Larobina1, Justin A Mariani, Michael A Rowland
1Department of Cardiothoracic Surgery, Alfred Hospital, Melbourne, Australia.
Insights
Aortic valve disease in donor hearts, previously a contraindication for cardiac transplantation, can be successfully managed. Donor hearts requiring aortic valve replacement can be safely used, expanding the donor pool for transplant candidates.
Area of Science:
- Cardiology
- Transplantation Medicine
- Cardiac Surgery
Background:
- Donor organ availability is limited for cardiac transplantation.
- Aortic valve disease in donor hearts has been an absolute contraindication.
- Concomitant surgeries like coronary bypass and mitral/tricuspid valve repair are accepted to expand the donor pool.
Observation:
- A case of cardiac transplantation using a donor heart with calcific aortic stenosis on a congenitally bicuspid aortic valve is presented.
- The donor aortic valve required concomitant aortic valve replacement during the transplantation procedure.
Findings:
- Successful transplantation was achieved with concomitant aortic valve replacement.
- Eighteen-month follow-up demonstrated excellent allograft function.
- The mechanical aortic prosthesis functioned normally, ensuring long-term viability.
Implications:
- Aortic valve disease in donor organs does not necessarily preclude transplantation.
- Aortic valve replacement at the time of transplant is a viable solution.
- This approach can expand the donor pool for marginal allografts, benefiting recipients needing cardiac transplants.
Abstract:
Although concomitant coronary bypass, and mitral and tricuspid valve surgery have been used to expand the donor pool for cardiac transplantation, aortic valve disease is considered an absolute contraindication for use of an offered organ. A case is presented with the successful use of an organ requiring concomitant aortic valve replacement for calcific aortic stenosis on a congenitally bicuspid valve. Eighteen-month follow-up documented excellent allograft function with a normally functioning mechanical aortic prosthesis. Aortic valve disease in offered organs can be successfully treated with aortic valve replacement at the time of transplantation and should not preclude the use of the organ in the setting of a recipient who is a candidate for a marginal allograft.
