Aortic Valve Replacement in the Donor Heart: A Case Report

Authors

• Joshua J. Lowman, University of LynchburgFollow

Specialty

Cardiothoracic Surgery

Advisor

Dr. Debra Munsell

Abstract

A persistent shortage of suitable donor hearts for orthotopic heart transplantation (OHT) continues to limit access to life-saving therapy and contributes to high waitlist mortality. One potential, yet underutilized strategy, the use of donor hearts with repairable organic valvular heart disease, presents a possible novel strategy to expand the donor pool, although evidence is limited. We present the case of a man in the seventh decade of life with non-ischemic dilated cardiomyopathy, supported by a durable left ventricular assist device, complicated by chronic driveline infection who underwent successful OHT utilizing an allograft with bicuspid aortic stenosis (AS) corrected intraoperatively during implantation using a bioprosthetic valve. The recipient’s short-term postoperative course was unremarkable with normal prosthetic aortic valve (AV) function and normal biventricular function on serial postoperative echocardiographic imaging. However, concerns about prosthetic valve durability, extended ischemic times, and potential late complications continue to restrict wider adoption. Advances in bioprosthetic valve design, transcatheter valve-in-valve therapies, and an evolving understanding of transplant physiology may help address these limitations; however, long-term outcomes have yet to be established.

Recommended Citation

Lowman JJ. Aortic Valve Replacement in the Donor Heart: A Case Report. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2026; 8(1).