A Successful Case of Heart Transplantation and Post-Transplant COVID-19 infection in a Patient with Cardiogenic Shock

Document Type : Case Report


1 Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Science, Tehran, Iran.

2 Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.

3 Department of Cardiology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran.


Cardiogenic shock is one of the main concerns for cardiologists, especially heart failure specialists, and in the majority of cases, the underlying mechanism is an extensive acute myocardial infarction. Despite various interventional and therapeutic advancements in the management of these patients, the mortality and morbidity of these patients remain high and most noninvasive therapies are considered ineffective. Urgent revascularization and application of short-term mechanical circulatory support devices and early referral to heart transplant centers may improve outcomes. Herein we describe a 50-year-old patient presenting with cardiogenic shock, who was successfully treated by VA-ECMO and urgent heart transplant and experienced COVID-19 infection post-transplant.


  1. Bahit MC, Kochar A, Granger CB. Post-myocardial infarction heart failure. JACC: Heart failure. 2018 Mar;6(3):179-86.
  2. De Luca L. Established and emerging pharmacological therapies for post-myocardial infarction patients with heart failure: a review of the evidence. Cardiovascular Drugs and Therapy. 2020 Oct;34(5):723-35.
  3. Kochar A, Doll JA, Liang L, Curran J, Peterson ED. Temporal trends in post myocardial infarction heart failure and outcomes among older adults. Journal of Cardiac Failure. 2022 Apr 1;28(4):531-9.
  4. Deng MC. Cardiac transplantation. Heart. 2002 Feb 1;87(2):177-84.
  5. Byrne RA, Rossello X, Coughlan JJ, Barbato E, Berry C, Chieffo A, et al. 2023 ESC Guidelines for the management of acute coronary syndromes: Developed by the task force on the management of acute coronary syndromes of the European Society of Cardiology (ESC). European heart journal. 2023 Oct 7;44(38):3720-826.
  6. Ostadal P, Rokyta R, Karasek J, Kruger A, Vondrakova D, Janotka M, et al. Extracorporeal membrane oxygenation in the therapy of cardiogenic shock: results of the ECMO-CS randomized clinical trial. Circulation. 2023 Feb 7;147(6):454-64.
  7. Perez-Villa B, Cubeddu RJ, Brozzi N, Sleiman JR, Navia J, Hernandez-Montfort J. Transition to heart transplantation in post-myocardial infarction ventricular septal rupture: a systematic review. Heart Failure Reviews. 2021 Oct 21:1-1.
  8. Duran JM, Lin AY, Barat M, Aslam S, Adler ED. Use of Remdesivir to Treat COVID-19 after Orthotopic Heart Transplant. The Journal of Heart and Lung Transplantation. 2021 Apr 1;40(4):S20.
  9. Duran JM, Barat M, Lin AY, King KR, Greenberg B, Adler ED, et al. Low mortality in SARS‐CoV‐2 infected heart transplant recipients at a single center. Clinical transplantation. 2022 Jan;36(1):e14443.
  10. Taghavi S, Jelodar HR, Rafati A, Naderi N, Mirtajaddini M, Amin A, et al. COVID-19 in heart transplant recipients. Journal of Cardiovascular and Thoracic Research. 2022;14(4):258.
  11. Hanson PJ, Liu-Fei F, Lai C, Toma M, McManus BM. COVID-19-positivity in a heart transplant recipient—antibody-mediated rejection or SARS-CoV-2-associated cardiac injury?. Oxford Medical Case Reports. 2022 Jan;2022(1):omab143.
  12. Lima B, Gibson GT, Vullaganti S, Malhame K, Maybaum S, Hussain ST, et al. COVID‐19 in recent heart transplant recipients: clinicopathologic features and early outcomes. Transplant Infectious Disease. 2020 Oct;22(5):e13382.