Partial Heart Transplant in a Neonate With Irreparable Truncal Valve Dysfunction

Abstract

ImportanceThe treatment of neonates with irreparable heart valve dysfunction remains an unsolved problem because there are no heart valve implants that grow. Therefore, neonates with heart valve implants are committed to recurrent implant exchanges until an adult-sized valve can fit.ObjectiveTo deliver the first heart valve implant that grows.Design, Setting, and ParticipantsCase report from a pediatric referral center, with follow-up for more than 1 year. Participants were a recipient neonate with persistent truncus arteriosus and irreparable truncal valve dysfunction and a donor neonate with hypoxic-ischemic brain injury.InterventionFirst-in-human transplant of the part of the heart containing the aortic and pulmonary valves.Main Outcomes and MeasuresTransplanted valve growth and hemodynamic function.ResultsEchocardiography demonstrated adaptive growth and excellent hemodynamic function of the partial heart transplant valves.Conclusions and RelevanceIn this child, partial heart transplant delivered growing heart valve implants with a good outcome at age 1 year. Partial heart transplants may improve the treatment of neonates with irreparable heart valve dysfunction.