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Background <p>Aortic valve dysfunction is a rare but relevant long-term complication after orthotopic heart transplantation (HTX). Treatment options include surgical (SAVR) and transcatheter (TAVR) aortic valve replacement, but evidence is limited to the level of case reports.</p> Methods <p>A total of 2054 patients underwent HTX between 1986 and 2023 at the Deutsches Herzzentrum der Charité, Berlin, Germany, 16 of them underwent aortic valve replacement (SAVR, N = 7; TAVR, N = 9) after HTX. In this case series we report on the outcomes of these 16 patients (age 29-73 years).</p> Results <p>Isolated aortic valve regurgitation occurs in 5 (31%) patients (TAVR N = 1, SAVR N = 4), while 11 patients (69%) suffer from aortic valve stenosis. Severe pre-procedural heart failure is present in 38% of the patients. Thirty-day mortality is 0%, in-hospital mortality is N = 2 (22%) patients due to sepsis, both patients were severely decompensated prior to TAVR. An uneventful postoperative course occurs in 8 (50%) patients, the patient’s functional status improves in 12 (75%) cases.</p> Conclusion <p>TAVR is the increasingly preferred treatment for aortic valve dysfunction after heart transplantation, but SAVR is a feasible alternative for individuals who are ineligible for TAVR. Further information is needed on the appropriate procedural timing in these high-risk patients.</p>

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Surgical and transcatheter aortic valve replacement after orthotopic heart transplantation: a case series

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月1日

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  • Luise Roehrich,
  • Hristian Hinkov,
  • Christoph Knosalla,
  • Felix Hennig,
  • Christoph Klein,
  • Marian Kukucka,
  • Nicolas Merke,
  • Laurenz Kopp Fernandes,
  • Isabell Anna Just,
  • Sascha Ott,
  • Henryk Dreger,
  • Volkmar Falk,
  • Axel Unbehaun,
  • Felix Schoenrath

摘要

Background

Aortic valve dysfunction is a rare but relevant long-term complication after orthotopic heart transplantation (HTX). Treatment options include surgical (SAVR) and transcatheter (TAVR) aortic valve replacement, but evidence is limited to the level of case reports.

Methods

A total of 2054 patients underwent HTX between 1986 and 2023 at the Deutsches Herzzentrum der Charité, Berlin, Germany, 16 of them underwent aortic valve replacement (SAVR, N = 7; TAVR, N = 9) after HTX. In this case series we report on the outcomes of these 16 patients (age 29-73 years).

Results

Isolated aortic valve regurgitation occurs in 5 (31%) patients (TAVR N = 1, SAVR N = 4), while 11 patients (69%) suffer from aortic valve stenosis. Severe pre-procedural heart failure is present in 38% of the patients. Thirty-day mortality is 0%, in-hospital mortality is N = 2 (22%) patients due to sepsis, both patients were severely decompensated prior to TAVR. An uneventful postoperative course occurs in 8 (50%) patients, the patient’s functional status improves in 12 (75%) cases.

Conclusion

TAVR is the increasingly preferred treatment for aortic valve dysfunction after heart transplantation, but SAVR is a feasible alternative for individuals who are ineligible for TAVR. Further information is needed on the appropriate procedural timing in these high-risk patients.