Partial heart transplant delivers durable, growing valves for repair of critical congenital heart defects

The trauma of birth followed by the trauma of surgery is a lot for a newborn to take on, but for babies born with critical congenital heart defects it is part of the fight for survival. And if the defect repair requires new heart valves, the initial repair surgery is just the first of many battles.

Replacement valves in use today, whether artificial or recovered from a donor, cannot grow along with the child, so they must be replaced several times before their recipients reach adulthood. This requires multiple open heart procedures, with all the risks, hardships and recovery involved.

Wanting to find a better way, T. Konrad Rajab, M.D., a pediatric cardiac surgeon at MUSC Shawn Jenkins Children’s Hospital, hatched the concept of partial heart transplantation to give children with valve defects the solution they need.

“Heart valve replacement is very successful in adults,” said Rajab. “We have excellent outcomes. But the problem for young children is that if you replace the valves, the heart valves don't grow with the children, which leads to a lot of problems and the need for future reoperations.”

Rajab had been contemplating this problem for years. And as he considered that a full heart transplant grows along with the patient, he wondered: what if you could transplant only the part of the heart that contains the valves? He called this concept a partial heart transplant and went to work to make it a reality.

He also partnered with the pediatric cardiology experts at Duke University, and in April 2022 he saw the fruition of his concept: the first human partial heart transplant was performed successfully at Duke in an 18-day-old baby with truncus arteriosus and a severely deformed truncal valve.

“The patient did very well,” Rajab said. “They were discharged around day 30, and on follow up we were thrilled to see that the valves continued to grow.”

Read the full Progressnotes article to learn more about the Dr Rajab's research that led to this innovative surgery.