Related Experiment Video
Updated: Sep 27, 2025
Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
Published on: May 21, 2017
Bench bioprosthetic aortic valve replacement in a donor heart before transplantation
Juan C Rendón1, Eric E Vinck1, Alejandro Quintero Gómez1
1Department of Cardiovascular Surgery, Cardio VID Clinic, Pontifical Bolivarian University, Medellín, Antioquia, Colombia.
Insights
Marginal donor hearts with valvular disease can be used in cardiac transplantation. A bicuspid aortic valve in a donor heart was successfully replaced during surgery, expanding donor heart eligibility.
Area of Science:
- Cardiology
- Transplantation Surgery
- Cardiac Surgery
Background:
- Critical donor shortages necessitate expanding donor heart eligibility criteria.
- Marginal donor hearts, previously deemed unsuitable, are increasingly considered.
- Donor valvular disease was historically an absolute contraindication for heart transplantation.
Observation:
- A 39-year-old male patient with end-stage non-compaction cardiomyopathy (INTERMACS II, LVEF 8%) underwent orthotopic heart transplantation.
- During donor graft examination, a congenital, calcified bicuspid aortic valve was identified.
- This finding presented a potential challenge to utilizing the donor heart.
Findings:
- The donor's native bicuspid aortic valve was surgically excised.
- Annular calcification associated with the valve was debrided.
- A #21 bioprosthetic aortic valve was successfully implanted into the donor heart.
Implications:
- This case demonstrates the feasibility of addressing donor valvular disease during heart transplantation.
- It suggests that marginal donor hearts with specific valvular abnormalities can be utilized.
- Expanding donor heart eligibility criteria may help alleviate donor shortages and improve patient outcomes.
Abstract:
Critical donor shortages have impulsed the need to expand donor heart eligibility through the use of marginal hearts in cardiac transplantation. Donor valvular disease has been considered as an absolute contraindication for transplant. A 39-year-old male patient with end-stage non-compaction cardiomyopathy, an INTERMACS II heart failure, and a left ventricular ejection fraction of 8% was taken to an orthotopic heart transplantation. During donor bench graft examination, a congenital bicuspid and calcified aortic valve was found. The native bicuspid valve was removed and the annular calcification debrided; a #21 bioprosthetic aortic valve was then implanted.
