Redo heart transplant for severe tricuspid regurgitation following orthotopic heart transplant

Tricuspid regurgitation is the commonest valve abnormality following orthotopic heart transplant. Although the clinical course of tricuspid regurgitation (TR) is heterogeneous, hemodynamically significant regurgitation generally leads to progressive right heart dysfunction and symptoms. We describe a patient who developed severe tricuspid regurgitation 8 months after successful heart transplant. He had sudden cardiac arrest needing prolonged cardiopulmonary resuscitation and ventilatory and dialysis support thereafter. In view of poor hemodynamic status, he subsequently underwent redo transplantation. After redo transplant, he had a stable postoperative course and now, 7 months down the course, has good biventricular function. This case is unique in that it is the first reported successful redo transplant in the country and one of the few occasions where a redo transplant had to be done for posttransplant tricuspid regurgitation.