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Autograft Aortic Root Replacement on Allograft During Heart Transplantation
Atsushi Nemoto1, Takeyoshi Ota1, Tae Song1
1Section of Cardiac Surgery, Department of Surgery, The University of Chicago Medicine, Chicago, Illinois.
Annals of Thoracic Surgery Short Reports
|January 10, 2025
Summary
This case study details a successful heart transplant using a donor heart with a bicuspid aortic valve. The aortic root was replaced with the recipient
Area of Science:
- Cardiology
- Cardiac Surgery
- Transplantation Immunology
Background:
- Bicuspid aortic valve (BAV) is a common congenital heart defect.
- Aortic insufficiency (AI) can complicate BAV, posing challenges for heart transplantation.
- Standard management for BAV with AI in transplant donors is not well-defined.
Purpose of the Study:
- To present a novel surgical technique for heart transplantation involving a donor heart with BAV and moderate AI.
- To demonstrate the feasibility and success of aortic root replacement using the recipient's autograft in back-bench preparation.
Main Methods:
- Donor heart retrieval with a bicuspid aortic valve and moderate aortic insufficiency.
- Back-bench preparation involving aortic root replacement with the recipient's autograft.
- Standard orthotopic heart transplantation procedure.
Main Results:
- Successful implantation of the prepared donor heart.
- Resolution of aortic insufficiency from the donor heart.
- Positive early post-transplant recovery.
Conclusions:
- Aortic root replacement with the recipient autograft is a viable strategy for managing BAV with AI in heart donors.
- This technique facilitates the use of otherwise marginal donor hearts.
- Successful heart transplantation is achievable even with complex donor valve anatomy.
