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Aortic valve replacement using On-X valve in a child postorthotopic heart transplantation

Lookup NU author(s): Dr Zdenka Reinhardt



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


A 20-month-old girl presented with severe dilated cardiomyopathy and decompensated congestive cardiac failure. Despite escalating inotropic and mechanical ventilation support, she required placement on extracorporeal membrane oxygenation and transfer to the transplant centre in Newcastle, England. She was placed on biventricular assist device and then Berlin Heart but failed to show any recovery of ventricular function. She underwent orthotopic heart transplantation at 2 years of age. She developed bacterial endocarditis with Enterococcus faecalis resulting in severe aortic valve regurgitation requiring aortic valve replacement with a 19 mm On-X valve (Airtivion) 11 days after her transplant. Given the size of the donor heart, it was possible to implant a 19-mm valve in this 12 kg child with minimal risk of patient prosthesis mismatch. She was anticoagulated with warfarin (On-X valve INR 2-3 for first 3 months; INR 1.5-2.0 thereafter). Although she suffered several other post-operative complications, including malabsorption, nasojejunal feeding, liver dysfunction, vertebral fractures, renal impairment and renal calcification, and need for repeat opening of her tracheostomy site following her initial decannulation, her aortic valve function has remained stable.

Publication metadata

Author(s): James A, Foley R, Murchan H, Hasan A, DeRita F, Reinhardt Z, McMahon CJ

Publication type: Article

Publication status: Published

Journal: Cardiology in the Young

Year: 2023

Volume: 33

Issue: 3

Pages: 485-486

Print publication date: 01/03/2023

Online publication date: 30/06/2022

Acceptance date: 07/06/2022

Date deposited: 27/03/2023

ISSN (print): 1047-951

ISSN (electronic): 1467-1107

Publisher: Cambridge University Press


DOI: 10.1017/S1047951122002001

PubMed id: 35770731


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