Mitral valve repair and redo repair for mitral regurgitation in a heart transplant recipient

• Published in: Journal of cardiothoracic surgery Vol. 7; no. 1; p. 100
• Main Authors: Bouma, Wobbe, Brügemann, Johan, Hamer, Inez J Wijdh-den, Klinkenberg, Theo J, Koene, Bart M, Kuijpers, Michiel, Erasmus, Michiel E, van der Horst, Iwan Cc, Mariani, Massimo A
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 29.09.2012; BioMed Central; BMC
• Subjects: Adult; Cardiology; Cardiovascular disease; Case Report; Coronary vessels; Echocardiography, Doppler; Heart; Heart attacks; Heart Transplantation; Heart Valve Prosthesis Implantation; Humans; Male; Mitral regurgitation; Mitral Valve - surgery; Mitral valve insufficiency; Mitral Valve Insufficiency - diagnostic imaging; Mitral Valve Insufficiency - surgery; Mitral valve repair; Prosthesis Failure; Reoperation; Transplantation; Treatment Outcome; Ultrasonic imaging
• ISSN: 1749-8090; 1749-8090
• DOI: 10.1186/1749-8090-7-100

A 37-year-old man with end-stage idiopathic dilated cardiomyopathy underwent an orthotopic heart transplant followed by a reoperation with mitral annuloplasty for severe mitral regurgitation. Shortly thereafter, he developed severe tricuspid regurgitation and severe recurrent mitral regurgitation due to annuloplasty ring dehiscence. The dehisced annuloplasty ring was refixated, followed by tricuspid annuloplasty through a right anterolateral thoracotomy. After four years of follow-up, there are no signs of recurrent mitral or tricupid regurgitation and the patient remains in NYHA class II. Pushing the envelope on conventional surgical procedures in marginal donor hearts (both before and after transplantation) may not only improve the patient's functional status and reduce the need for retransplantation, but it may ultimately alleviate the chronic shortage of donor hearts.