After the 20th day, the patient underwent orthotopic heart transplant. The explanted heart’s pathological examination revealed dilated cardiomyopathy without a specific etiology, leading to the diagnosis of idiopathic dilated cardiomyopathy (Figure 4).
Following the successful transplant, the overall clinical condition showed improvement, enabling the removal of all mechanical circulatory support and the discontinuation of antibiotics within 7 days. Voriconazole was continued to treat probable IPA, in addition to immunosuppressive drugs such as tacrolimus, mycophenolic acid, and prednisolone.