Successful treatment of acute dissection of the donor aorta after orthotopic heart transplantation.

Acute aortic dissection is one of the rare aortic complications that occur after orthotopic heart transplantation. We report the second case of successful surgical treatment of aortic dissection confined to the donor aorta in a recipient of an orthotopic cardiac allograft. A 68-year-old patient was admitted with chest pain and shortness of breath 7 years after orthotopic heart transplantation. He previously had undergone twice coronary artery bypass grafting. Echocardiography revealed acute dissection of the donor aorta. The patient underwent urgent Bentall procedure with a prosthetic conduit. The post-operative course was uneventful. The heart donor was a 40-year-old man with known arterial hypertension and who had received long-term ergotamine tartrate therapy for migraine. This case demonstrates that heart-transplant recipients with arterial hypertension and donor-related risk factors are prone to aortic complications and require careful follow-up.