Transcatheter aortic valve replacement 24 years after cardiac transplantation

Wallen, Tyler; Spratt, John R.; Kates, Malcolm M.; Wayangankar, Siddharth A.; Vilaro, Juan; Aranda, Juan M.; Arnaoutakis, George J.

doi:10.1111/jocs.14438

Cited by 3 publications

(6 citation statements)

References 15 publications

(22 reference statements)

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“…Furthermore, it has been indicated that there was insufficient information about the surgical treatment of late complications after heart transplantation. [ 15 ] Normally, a contraindication to harvest a graft is the presence of any echocardiographic valvular changes, and yet, valve procedures can be performed on marginal donors before the transplantation, and this can help expand the donor pool without affecting outcomes. [ 16 , 17 ] Moreover, it is well-known that valvular dysfunction following cardiac transplantation is not as frequent as CAV, a condition that is responsible for long-term graft dysfunction.…”

Section: Discussionmentioning

confidence: 99%

“…[30] In addition, AS is identified in 11 patients in this review. [6,15,[31][32][33][34][35][36][37][38] Two of the patients underwent cardiac transplantation with a graft that has bicuspid aortic valve. [31,38] Bicuspid aortic valve is the most common congenital valvular abnormality in which only two cusps of the aortic valve are present since the separation of valve cusps does not happen in the fetal period.…”

Section: Discussionmentioning

confidence: 99%

“…Jordan et al [43] 2022 Systematic review Lopez-Vilella et al [12] 2022 Retrospective Martinez-Sellés et al [44] 2021 Retrospective Nersesian et al [52] 2021 Case report Roth et al [11] 2021 Case report Wallen et al [15] 2020 Case report Wosten et al [53] 2020 Case report Avula et al [32] 2019 Case report Bishawi et al [13] 2019 Retrospective 542 542 52 74.7 NR Farag et al [22] 2019 Retrospective 479 16 60.7 87.5 6.1…”

Section: Patient Demographicsmentioning

confidence: 99%

“…Akleh et al [31] 2018 1 AS C: 1 Campany et al [40] 2022 2 TAVR 0/2 0 Jordan et al [43] 2022 2 TV surgery, 7 MV surgery, 5 AV surgery 3/19 15.79 Lopez-Vilella et al [12] 2022 1 TV annuloplasty, 1 PCI, 196 conservative 88/200 44 Martinez-Sellés et al [44] 2021 10 Antimicrobial therapy only, 1 MVR + Antimicrobial therapy 5/11 45.45 Nersesian et al [52] 2021 1 TMVR 0/1 0 Roth et al [11] 2021 PTVR 0/2 0 Wallen et al [15] 2020 1 TAVR 0/1 0 Wosten et al [53] 2020 1 PTVR NR Avula et al [32] 2019 1 TAVR 0/1 0 Bishawi et al [13] 2019 6 TV repair, 536 no or conservative 9/542 1.66 Farag et al [22] 2019 5 TVR (1 mechanical, 4 bioprosthetic) 7 TV repair 6 MVR (mechanical) 2/16 12.50…”

Section: Diagnosismentioning

confidence: 99%

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Management options of valvular heart diseases after heart transplantation: A scoping review

Yilmaz,

Keenan

2024

Turk Gogus Kalp Dama

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Background: This study aimed to outline the valvular changes following heart transplantation and describe the management options to address these conditions. Methods: A literature search using EMBASE, MEDLINE, and PubMed databases was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines in this study. Clinical studies involving patients who had their first heart transplant and articles that mentioned management for valvular heart disease were included. Treatment options were grouped into four categories: cardiac surgery other than retransplant and valve surgery, valve replacement and repairs, nonsurgical interventions, and conservative management. Results: Nine hundred and three (6.56%) patients out of 13,757 patients (10,529 males, 3,228 females; mean age: 60.3±10.4 years; range, 20 to 83 years) undergoing heart transplantation were identified with valvular disease affecting one or more valves. The mean interval between the transplant and the diagnosis of valve disease was 11.31±6.95 years. The most common valvular heart disease was tricuspid regurgitation, with 796 (94.09%) occurrences, followed by mitral regurgitation (n=22, 2.6%), aortic regurgitation (n=14, 1.65%), aortic stenosis (n=11, 1.3%), and mitral stenosis (n=3, 0.35%). Additionally, the number of surgical valve replacement and repairs (n=89) was higher than nonsurgical interventions (n=20). Conclusion: Acquired valvular heart diseases after cardiac transplantation are an infrequent clinical presentation that can cause valvular changes in the recipient. According to the extracted data, there is no sole superior management option, and more research is needed in this area.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Patient Demographicsmentioning

confidence: 99%

Section: Diagnosismentioning

confidence: 99%

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Management options of valvular heart diseases after heart transplantation: A scoping review

Yilmaz,

Keenan

2024

Turk Gogus Kalp Dama

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“…Furthermore, organ recipients have begun receiving TAVR with good results. TAVR has been described in heart transplant patients as early as 2010 [ 1 ], and has been attempted at increasing intervals from the original transplant, with cases showing success at 9 [ 1 ], 14 [ 2 ], and greater than 20 years after transplant in patients with aortic stenosis [ 3 , 4 ]. Similarly, TAVR has begun to be used off-label to treat aortic insufficiency in similar patient populations with good results [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Transcatheter aortic valve replacement 23 years after heart transplant for aortic insufficiency

Jones,

Amirjamshidi,

Olverson

et al. 2023

J Cardiothorac Surg

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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.

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Detailed mechanism of aortic valve stenosis following heart transplantation

Imamura

2020

J Card Surg

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Transcatheter aortic valve replacement 24 years after cardiac transplantation

Cited by 3 publications

References 15 publications

Management options of valvular heart diseases after heart transplantation: A scoping review

Management options of valvular heart diseases after heart transplantation: A scoping review

Transcatheter aortic valve replacement 23 years after heart transplant for aortic insufficiency

Detailed mechanism of aortic valve stenosis following heart transplantation

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