title: Mitral valve repair and redo repair for mitral regurgitation in a heart transplant recipient.
abstract: 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.
authors.affiliation: Department of Cardiothoracic Surgery, University Medical Center Groningen, Groningen, the Netherlands. w.bouma@umcg.nl
authors.forename: Wobbe
authors.initials: W
authors.lastname: Bouma
authors.forename: Johan
authors.initials: J
authors.lastname: Brügemann
authors.forename: Inez J Wijdh-den
authors.initials: IJ
authors.lastname: Hamer
authors.forename: Theo J
authors.initials: TJ
authors.lastname: Klinkenberg
authors.forename: Bart M
authors.initials: BM
authors.lastname: Koene
authors.forename: Michiel
authors.initials: M
authors.lastname: Kuijpers
authors.forename: Michiel E
authors.initials: ME
authors.lastname: Erasmus
authors.forename: Iwan Cc
authors.initials: IC
authors.lastname: van der Horst
authors.forename: Massimo A
authors.initials: MA
authors.lastname: Mariani
mesh_terms: D000328:Adult; D015150:Echocardiography, Doppler; D016027:Heart Transplantation; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery*; D011475:Prosthesis Failure; D012086:Reoperation; D016896:Treatment Outcome