Transcatheter aortic valve replacement 23 years after heart transplant for aortic insufficiency
Abstract Background Clinicians continue to expand the availability of transcatheter aortic valve replacement (TAVR) for patients who historically would have been ineligible for surgical aortic valve replacement. Historically, reoperative aortic valve surgery after transplant was immensely complicate...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-10-01
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| Series: | Journal of Cardiothoracic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13019-023-02407-x |
| _version_ | 1797556495020195840 |
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| author | Andrew Jones Hossein Amirjamshidi George Olverson Frederick S. Ling Kazuhiro Hisamoto |
| author_facet | Andrew Jones Hossein Amirjamshidi George Olverson Frederick S. Ling Kazuhiro Hisamoto |
| author_sort | Andrew Jones |
| collection | DOAJ |
| description | Abstract Background Clinicians continue to expand the availability of transcatheter aortic valve replacement (TAVR) for patients who historically would have been ineligible for surgical aortic valve replacement. Historically, reoperative aortic valve surgery after transplant was immensely complicated and high risk due to the repeat sternotomy approach, and the immunosuppression in transplant patients. As heart transplant patients continue to live longer, patients are beginning to develop novo aortic pathology of the transplanted organ. In these patients, TAVR may be a valuable rescue therapy for those with de-novo aortic valve disease. Case presentation Here, we present a single case of a 70-year-old man with a history of heart transplant 23 years prior complicated by severe sternal infection and subsequent removal of his sternum. Additionally, this patient had a recent history of kidney transplant due to renal cell carcinoma necessitating nephrectomy. He subsequently developed progressive symptomatic aortic insufficiency and underwent a successful TAVR to treat his new aortic disease. Conclusions To our knowledge, this represents only the second case report of TAVR for severe aortic insufficiency and one of the first reports of TAVR in a multiple organ recipient. TAVR may represent an important rescue therapy for post-transplant valve pathologies instead of high-risk reoperative surgical aortic valve replacement. |
| first_indexed | 2024-03-10T17:03:43Z |
| format | Article |
| id | doaj.art-363e5b9deea24f5d91fac3dbca9434f7 |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-03-10T17:03:43Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-363e5b9deea24f5d91fac3dbca9434f72023-11-20T10:52:51ZengBMCJournal of Cardiothoracic Surgery1749-80902023-10-011811510.1186/s13019-023-02407-xTranscatheter aortic valve replacement 23 years after heart transplant for aortic insufficiencyAndrew Jones0Hossein Amirjamshidi1George Olverson2Frederick S. Ling3Kazuhiro Hisamoto4University of Rochester School of Medicine and DentistryDivision of Cardiac Surgery, Department of Surgery, University of Rochester Medical CenterUniversity of Rochester School of Medicine and DentistryDepartment of Medicine, Cardiology, University of Rochester Medical CenterDivision of Cardiac Surgery, Department of Surgery, University of Rochester Medical CenterAbstract Background Clinicians continue to expand the availability of transcatheter aortic valve replacement (TAVR) for patients who historically would have been ineligible for surgical aortic valve replacement. Historically, reoperative aortic valve surgery after transplant was immensely complicated and high risk due to the repeat sternotomy approach, and the immunosuppression in transplant patients. As heart transplant patients continue to live longer, patients are beginning to develop novo aortic pathology of the transplanted organ. In these patients, TAVR may be a valuable rescue therapy for those with de-novo aortic valve disease. Case presentation Here, we present a single case of a 70-year-old man with a history of heart transplant 23 years prior complicated by severe sternal infection and subsequent removal of his sternum. Additionally, this patient had a recent history of kidney transplant due to renal cell carcinoma necessitating nephrectomy. He subsequently developed progressive symptomatic aortic insufficiency and underwent a successful TAVR to treat his new aortic disease. Conclusions To our knowledge, this represents only the second case report of TAVR for severe aortic insufficiency and one of the first reports of TAVR in a multiple organ recipient. TAVR may represent an important rescue therapy for post-transplant valve pathologies instead of high-risk reoperative surgical aortic valve replacement.https://doi.org/10.1186/s13019-023-02407-xTranscatheter aortic valve replacementHeart transplantationAortic valve insufficiencyAortic valveKidney transplantation |
| spellingShingle | Andrew Jones Hossein Amirjamshidi George Olverson Frederick S. Ling Kazuhiro Hisamoto Transcatheter aortic valve replacement 23 years after heart transplant for aortic insufficiency Journal of Cardiothoracic Surgery Transcatheter aortic valve replacement Heart transplantation Aortic valve insufficiency Aortic valve Kidney transplantation |
| title | Transcatheter aortic valve replacement 23 years after heart transplant for aortic insufficiency |
| title_full | Transcatheter aortic valve replacement 23 years after heart transplant for aortic insufficiency |
| title_fullStr | Transcatheter aortic valve replacement 23 years after heart transplant for aortic insufficiency |
| title_full_unstemmed | Transcatheter aortic valve replacement 23 years after heart transplant for aortic insufficiency |
| title_short | Transcatheter aortic valve replacement 23 years after heart transplant for aortic insufficiency |
| title_sort | transcatheter aortic valve replacement 23 years after heart transplant for aortic insufficiency |
| topic | Transcatheter aortic valve replacement Heart transplantation Aortic valve insufficiency Aortic valve Kidney transplantation |
| url | https://doi.org/10.1186/s13019-023-02407-x |
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