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

Wobbe Bouma1*, Johan Brügemann2, Inez J Wijdh-den Hamer1, Theo J Klinkenberg1, Bart M Koene1, Michiel Kuijpers1, Michiel E Erasmus1, Iwan CC van der Horst2 and Massimo A Mariani1

Author Affiliations

1 Department of Cardiothoracic Surgery, University Medical Center Groningen, Groningen, the Netherlands

2 Department of Cardiology, University Medical Center Groningen, Groningen, the Netherlands

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Journal of Cardiothoracic Surgery 2012, 7:100  doi:10.1186/1749-8090-7-100

Published: 29 September 2012


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.

Heart transplantation; Mitral regurgitation; Mitral valve repair; Reoperation