Heart Transplantation in a Patient With Rheumatic Heart Disease and Severe Left Atrial Calcification

Area of Science:

• Cardiovascular Surgery
• Cardiac Transplantation
• Medical Device Technology

Background:

• A 62-year-old female patient with end-stage heart failure (Stage D) required a heart transplant.
• The patient had a history of mitral valve replacement 24 years prior.
• Preoperative imaging revealed severe left atrial calcification and an enlarged right atrium.

Observation:

• The extreme calcification of the left atrium precluded standard suturing techniques for anastomosis.
• A novel surgical approach was necessary to address the non-suturable atrial wall.

Findings:

• The surgical team performed a broad resection of the severely calcified left atrial wall.
• Reconstruction was achieved using a bovine pericardial patch, facilitating anastomosis with the donor heart.
• The procedure was completed successfully without significant hemorrhage.

Implications:

• This case demonstrates the successful use of bovine pericardial patch reconstruction for severely calcified atria during heart transplantation.
• The technique provides a potential solution for complex atrial anastomosis in challenging cardiac surgical cases.
• Successful patient discharge without complications highlights the efficacy and safety of this reconstructive approach.