Boston Children's performs elective partial heart transplant

Boston Children's cardiac surgeons might have been the first to complete a partial heart transplant as an elective procedure.

Surgeons performed a partial heart transplant on a 4-year-old boy with aortic valve stenosis, according to an Aug. 1 system news release. The boy had already undergone two fetal cardiac interventions and a surgical valve repair in his first year of life, but still had residual aortic valve disease. The team decided he needed a new aortic valve and briefly considered the Ross procedure, a last-option treatment.

The team decided that a partial heart transplant could be the best option. The world's first partial transplant was performed by Durham, N.C.-based Duke University Hospital in 2022, and few other heart centers have undertaken the procedure since. The Boston Children's team established protocols for a partial heart transplant eight years ago, but had not yet found an ideal patient until this year, according to the release.

The team found a donor heart that had good working valves. They worked through the night and into the next day to remove the aortic valve from the donor heart and place it in the boy's heart. 

This partial transplant appears to be the first on a patient who wasn't critically ill and had options for another procedure, Sitaram Emani, MD, surgical director of the adult congenital heart program, director of the complex biventricular repair program and surgical director of the division of cardiovascular critical care, said in the release.

The boy is doing well and should only require a smaller amount of immunosuppressives over the course of several months.

The cardiac surgery team is already reviewing how they could replace other valves of the heart.

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