Aim. Coronary artery bypass grafting (CABG) and tricuspid valve replacement (TVR) are available therapeutic options for cardiac allograft vasculopathy (CAV) and tricuspid regurgitation (TR), respectively after orthotopic heart transplantation (OHT). To our knowledge, these two procedures have never been reported simultaneously in a heart transplant recipient in the literature.

Materials and methods. We present the first incidence of a simultaneous CABG and TVR with a BiocorTMbioprosthetic valve in a heart transplant recipient 25 years after the original transplant operation, the longest reported duration before reoperation after OHT.

Results. Early postoperative course was complicated by complete heart block requiring placement of dual chamber pacemaker. Patient progressed well after this intervention and was eventually discharged to home and remained asymptomatic on follow-up.

Conclusion. Concomitatnt CAV and TVR for severe TR is a safe and effective treatment option with low perioperative mortality and favorable short and long term outcomes in heart transplant recipients.