2024-01-09 19:00:06
Owen Monroe, shortly before heart transplant, in 2022.
More than fourteen months after having benefited from a new type of heart transplant, consisting of transplanting only the part of the heart containing the valves ensuring the ejection of blood from the organ, little Owen Monroe is doing well . This is what the surgical team reported on January 2 in the journal JAMA.
Then aged 18 days, the infant was operated on in April 2022 at the Thoracic and Cardiac Surgery Center at Duke University (North Carolina). The two large vessels at the base of the heart did not emerge independently, but formed a single truncus arteriosus associated with a single, defective valve. Additionally, the ventricles communicated with each other. This child had what is called truncus arteriosus (common trunk arteriosus), associated with a dysfunction of this unique valve. More than half of children with this rare congenital heart disease die before the age of 6 months.
Instead of transplanting an entire heart from a donor baby to a recipient baby, surgeons grafted only the valves that allow blood to flow into the aorta and pulmonary artery. The native ventricles remained in place.
Transplantation « domino »
Thanks to this procedure, a world first, we can hope that the transplanted valves will grow with the child. that’s what happened. “Echocardiographic examinations showed suitable growth of the transplanted valves. No obstruction or insufficiency of the aortic and pulmonary valves was observed,” say Joseph Turek and his colleagues at Duke University.
Owen received the valves from a little girl who survived only two days. When his heart stopped working, surgeons removed the aortic and pulmonary valves and re-implanted them into Owen’s heart. The operation lasted six and a half hours. The immunosuppressive treatment used corresponds to a quarter of the doses necessary for the transplantation of a whole heart.
According to Joseph Turek, this innovation paves the way for a so-called “domino” heart transplant. When we transplant an entire heart into a patient with only the ventricles damaged, we can recover the healthy heart valves from the heart that we remove to transplant them to another patient: “We could thus potentially double the number of hearts used for the benefit of children suffering from heart disease. » Since the first one carried out on little Owen, other interventions of this type have followed.
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