Heart transplantation using a donor heart with repaired tetralogy of Fallot: a case report.

Abstract

Background:

Heart transplantation is the gold standard therapy for end-stage heart failure; however, it is limited by a shortage of available donors. In recent years, heart transplantations have been performed using marginal donor hearts with valvular and/or congenital cardiac abnormalities.

Case summary:

A 60-year-old woman with acromegalic cardiomyopathy underwent left ventricular assist device implantation and aortic valve (AV) closure 4 years prior. After 2 months, repeat AV closure and omental flap transposition were performed. During the outpatient follow-up, the patient developed recurrent severe AV regurgitation and bacteraemia-induced subarachnoid haemorrhage. She underwent urgent heart transplantation using a marginal donor heart with preserved cardiac function, mild pulmonary valve stenosis, and regurgitation after pulmonary valve-sparing tetralogy of Fallot (TOF) repair. An anatomical anastomosis was possible. She had no signs of infection, heart failure, arrhythmia, or immune rejection 15 months after the heart transplantation.

Discussion:

In this case, the donor heart with repaired TOF did not require pulmonary valve replacement and was anatomically intact. Donor hearts with repaired TOF that are expected to have long-term durability in terms of cardiac function may be used for successful heart transplantations. The repair of marginal donor hearts creates an opportunity to increase the number of viable donors.

• Authors: Takura Taguchi, Daisuke Yoshioka, Koichi Toda, Shigeru Miyagawa
• Journal: European heart journal. Case reports (Eur Heart J Case Rep) Vol. 8 Issue 1 Pg. ytad557 (Jan 2024) ISSN: 2514-2119 [Electronic] England
• PMID: 38192270 (Publication Type: Case Reports)
• Copyright: © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.