How is a heart valve transplant different from a full heart transplant?
In a valve transplant, also called a partial heart transplant, only the valve(s) from a donor heart are used–not the entire heart. The child’s own heart remains in place, and only the damaged valve is replaced. This makes the procedure less invasive than a full heart transplant and allows donor hearts to help more than one patient.
Why might a child need a valve transplant?
A child may need a valve transplant if they have a congenital heart defect that impacts the aortic or pulmonary valves.
What conditions can a valve transplant help treat?
Children with congenital heart disease may benefit from a heart valve transplant. Heart valve transplants can help treat:
- Truncus arteriosus
- Pulmonary atresia or stenosis
- Aortic valve stenosis or regurgitation
- Endocarditis (infected heart valves)
- Failed previous valve repair or replacement
What is a domino valve transplant?
A domino transplant is a procedure in which one child receives a full heart transplant, and then the healthy valves from their old heart are removed and transplanted into another child needing a valve replacement. This procedure allows doctors to help multiple children with just one donor heart.
What are the benefits of “living” valves vs. other types of valves for children?
- Living tissue valves can grow with the child, reducing the need for multiple surgeries. They also function more like natural heart valves.
- Unlike mechanical valves, living valves don’t require lifelong blood thinners, which can be problematic for children.
- Living valves may last longer and perform better than cryopreserved tissue valves.
What kind of follow-up care is needed after a valve transplant?
Because the valve comes from a donor, the child typically needs immunosuppressive medications and specialized care to prevent rejection. These are managed carefully by a pediatric transplant team.
What is recovery like after a valve transplant?
- Children usually recover well and go home relatively quickly after surgery.
- Initial follow-up is done with the transplant team, then care is transferred back to the child’s regular cardiologist.
- Most patients can return to normal activities, with some long-term monitoring.
How long do transplanted valves last?
The long-term durability is still being studied, but living donor valves have shown promise in maintaining function. So far, many children have not needed further surgeries since their transplant.
Is this a common procedure?
No — heart valve transplant in pediatrics is a relatively new and pioneering approach. Only a few centers in the U.S., including NewYork-Presbyterian Morgan Stanley Children’s Hospital of Children’s Hospital of New York, are performing valve transplants in children, including domino procedures. However, early outcomes are promising.
What are the risks of valve transplant in children?
As with any major surgery, risks include:
- Bleeding or infection
- Rejection of the valve
- Complications from immunosuppressive therapy
These risks are managed by an experienced pediatric heart and transplant team.
