Regurgitation of the Native Aortic Valve Caused by Thrombus Formation After Heterotopic Heart Transplantation

A 61-year-old man, who had undergone heterotopic heart transplantation, had severe regurgitation through his native aortic valve develop 16 years later, which caused severe heart failure. At operation the regurgitation was found to be due to development of an organized thrombus in the sinuses of Valsalva tethering aortic leaflets. The management of this previously undescribed complication of heterotopic heart transplantation and the implications for other groups of patients (such as those receiving treatment with a left ventricular assist device) are discussed.