Nowadays, we need to deal with heart transplanted patients for other medical concerns. So, it is important to see in detail different aspects and modalities of their care during other types of surgery. A transplant team will carefully monitor each heart trans-plant recipient and should be possible to seek information on the patient's overall status. They will be able to inform on the most recent investigations (ECG to assess graft function, recent biopsy for rejection, angiography for

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... , etc.). Case report: Our patient, a 65-year-old lady underwent heart transplantation 5 years before. The cardiac situation was stable and she was doing fine. She was recovered in the gynaecological clinic with a diagnosis of vaginal prolapse with surgical indication General anaesthesia was done with fentanyl 7 ml, pavulon 4 mg, propofol 200 mg and sevoflurane 1.5-2.2%. The patient was monitored during surgery with SpO2, ECG, IBP, CVP. The operation technique was open of vaginal plastic repaire. Discussion: By 3 months, most recipients of heart transplant came under New York Heart Association (NYHA) I class. The last UK national survey about health-related quality of life after cardiac transplantation indicates that, 1 year after surgery, there is an improvement in quality of life (60% are much better; 28% somewhat better) and there is no deterioration in general health at 3–5 years, except that many of them have symptoms compatible with depression. Conclusion: Perioperative care of heart transplant recipients will entail a greater attention to maintaining an adequate preload and vascular tone, to avoiding infections and to being aware of the multiple side effects of immunosuppressive therapy. References and recommended reading papers of particular interest, published within the annual period of review, have been highlighted as of special interest of outstanding interest Additional references related to this topic can also be found in the Current World Literature section in this issue.