Key result
Multivalvular surgery yields clinical recovery and preserved ventricular function in a long-term heart transplant recipient.
Why the study?
Late clinical decline after heart transplantation is commonly attributed to rejection, allograft vasculopathy, or ventricular dysfunction, but progressive structural valvular disease with preserved graft function is less emphasized.
Does bioprosthetic aortic and mitral valve replacement and tricuspid repair improve symptoms in a long-term heart transplant recipient presenting with late progressive multivalvular regurgitation?
Case Report (n=1)
Does bioprosthetic aortic and mitral valve replacement and tricuspid repair improve symptoms in a long-term heart transplant recipient presenting with late progressive multivalvular regurgitation?
Progressive structural multivalvular disease should be considered as a cause of late clinical decline in heart transplant recipients, even when graft systolic function is preserved.
May warrant valvular evaluation in late post-transplant decline despite preserved function; leaves open prevalence and surveillance needs.
BACKGROUND: Late clinical decline after heart transplantation is commonly attributed to rejection, cardiac allograft vasculopathy, or ventricular dysfunction. Progressive structural valvular disease is less frequently emphasized when graft systolic function is preserved. CASE SUMMARY: A 22-year-old woman underwent orthotopic heart transplantation at age 13 for familial restrictive cardiomyopathy. Nearly 10 years later, she developed progressive exertional fatigue, reduced exercise tolerance, and dizziness despite preserved graft systolic function and no significant cardiac allograft vasculopathy. Serial imaging demonstrated severe mitral regurgitation, moderate to severe aortic regurgitation, and moderate to severe tricuspid regurgitation. She underwent redo sternotomy with bioprosthetic aortic and mitral valve replacement and tricuspid repair, with preserved ventricular function and clinical recovery at early follow-up. DISCUSSION: This case highlights progressive multivalvular disease as an important valve-level cause of late clinical decline after heart transplantation. TAKE-HOME MESSAGE: Consider structural valvular disease in symptomatic long-term heart transplant recipients with preserved graft function.
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Fanous et al. (2026) conducted a case report in Late progressive multivalvular regurgitation after heart transplantation (n=1). Redo sternotomy with bioprosthetic aortic and mitral valve replacement and tricuspid repair was evaluated on Clinical recovery with preserved ventricular function. Redo sternotomy with valve replacement and repair resulted in clinical recovery and preserved ventricular function in a long-term heart transplant recipient with progressive multivalvular disease.
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