DOI: 10.1093/jscr/rjag775 ISSN: 2042-8812
Orthotopic heart transplantation associated with hemiarch reconstruction for advanced heart failure and chronic aortic dissection: a case report
Oscar Edinson Sánchez, Valentina Pérez-Ariza, Roberto H Cruz Buitrago, Juan F Parra, William Rios, Federico NuñezAbstract
Concomitant orthotopic heart transplantation and aortic arch replacement are extremely rare, particularly in chronic Stanford type A dissection. A 43-year-old man with end-stage heart failure and chronic aortic dissection underwent combined orthotopic heart transplantation and hemiarch replacement. Because of concomitant liver donation, the donor inferior vena cava required pericardial patch reconstruction. Despite early right ventricular dysfunction requiring veno-arterial ECMO, the patient recovered completely and was discharged with preserved graft function. This case demonstrates the feasibility of a single-stage combined approach with excellent postoperative outcomes in carefully selected patients.