Bench Mitral Valve Repair of Donor Hearts Before Orthotopic Heart Transplantation

Cardiac transplantation remains the most effective therapy for end-stage heart failure in appropriate candidates, with a median posttransplant survival of 10 years. At any given point of time there are ≈3000 candidates on the heart transplant waiting list in the United States with annual mortality on the waiting list ≈15%. The number of heart transplants performed in the United States per year has been fairly constant at ≈2500. In spite of this, many donor hearts remain unused. Bench repair of mitral valves remains rarely practiced and significant mitral valve regurgitation (MR) remains a standard contraindication to use of a donor heart.A 53-year-old male donor who had a cerebral infarct became available for a 61-year-old man with blood group O who received left ventricular assist device, Heartmate II (Thoratec, Pleasanton, CA), for decompensated dilated cardiomyopathy. The donor coronary angiogram was normal. Donor transthoracic echocardiogram (TTE) showed inferior wall hypokinesis, interventricular septum 1.15 cm, …