Surgical Treatment for Spinal Scoliosis in Patient With Mitochondrial Disease After Heart Transplantation: A Case Report and Literature Review

Background: We present an extremely rare case of scoliosis surgery for mitochondrial disease after heart transplantation. Case Presentation: An 18-year-old female patient with mitochondrial disease underwent heart transplantation for dilated cardiomyopathy at age 12. After heart transplantation, she presented with progressive scoliosis with a Cobb angle of 101°. Therefore, we performed spinal correction and fusion surgery under strict management. Postoperative spinal radiography revealed successful spinal correction and maintained correction 2 years after surgery. Conclusions: This is the first report of scoliosis surgery in a patient with mitochondrial disease after heart transplantation. Scoliosis surgery in patients after heart transplantation requires strict management of the circulating intravascular volume, because the denervated heart is preload-dependent. Moreover, patients with mitochondrial disease should be treated for lactic acidosis caused by surgical stress and perioperative electrolyte abnormalities. Our case showed successful performance in minimizing invasiveness without compromising the surgical goals of correction and fusion.