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Published on: July 18, 2014
Transcatheter aortic valve implantation after heart transplantation
Giuseppe Bruschi1, Federico De Marco, Jacopo Oreglia
1A De Gasperis Cardiology & Cardiac Surgery Department, Niguarda Ca' Granda Hospital, Milan, Italy. giuseppe.bruschi@fastwebnet.it
Insights
Transcatheter aortic valve implantation is a safe and effective treatment for severe aortic stenosis in heart transplant recipients. This minimally invasive procedure improved the patient's allograft function and quality of life.
Area of Science:
- Cardiology
- Transplantation Medicine
- Interventional Cardiology
Background:
- Conventional cardiac surgery post-orthotopic heart transplantation is rare.
- Severe symptomatic aortic stenosis can develop years after heart transplantation.
Observation:
- A 67-year-old male heart transplant recipient developed severe aortic stenosis 9 years post-transplant.
- Transcatheter aortic valve implantation (TAVI) was chosen over conventional surgery due to the patient's condition.
Findings:
- The CoreValve prosthesis was successfully implanted percutaneously via the femoral artery.
- The patient remained asymptomatic and in New York Heart Association functional class II at 4 months post-procedure.
Implications:
- TAVI is a safe and suitable option for select heart transplant patients with aortic stenosis.
- This approach can potentially improve allograft function in heart transplant recipients.
Abstract:
Conventional cardiac surgical procedures after orthotopic heart transplantation are generally uncommon. We report the case of a 67-year-old man who had severe symptomatic aortic stenosis develop 9 years after heart transplantation. After joint evaluation of the cardiovascular team, transcatheter aortic valve implantation was preferred due to patient medical conditions. The CoreValve prosthesis (Medtronic, Minneapolis, MN) was inserted percutaneously into the femoral artery. At 4 months postoperatively, the patient is asymptomatic in New York Heart Association functional class II. This case report provides evidence that transcatheter aortic valve implantation is safe and suitable for selected patients with severe aortic stenosis and a history of heart transplantation that must improve allograft function.
