Josef Besik1, Ondrej Szarszoi2, Marketa Hegarova3, Miroslav Konarik1, Michal Smetana1, Ivan Netuka1, Jan Pirk1, Jiri Maly1. 1. Department of Cardiovascular Surgery, Institute for Clinical and Experimental Medicine, Prague, Czech Republic. 2. Department of Cardiovascular Surgery, Institute for Clinical and Experimental Medicine, Prague, Czech Republic. Electronic address: ondrej.szarszoi@ikem.cz. 3. Department of Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
Abstract
BACKGROUND: As a result of improved diagnostic methods, medical treatment, surgical correction, and palliation in childhood, there is a growing number of adult patients with congenital heart disease (CHD) who may experience heart failure and subsequently require heart transplantation (HT). Because of complex anatomy, previous operations, and frequently increased pulmonary vascular resistance (PVR), these patients represent a group with a higher risk of early mortality after transplantation. METHODS: From May 1999 to December 2014, our institution performed 25 HTs in adult patients with end-stage CHD. We present our data and outcomes of transplantation in this group. RESULTS: The median age at transplantation was 38 years (range, 18.4-53.7 years). Survival was 88% at 30 days, 88% at 1 year, and 77% at 5 years. We identified long donor heart ischemic time (>4 hours) as an important risk factor for early mortality. There was no significant difference in the survival of patients undergoing transplantation for CHD and patients undergoing transplantation for other diagnoses. CONCLUSIONS: With careful donor and recipient selection, adults with end-stage CHD undergoing HT can achieve excellent early and midterm survival, comparable to the survival of patients who undergo transplantation for other diagnoses.
BACKGROUND: As a result of improved diagnostic methods, medical treatment, surgical correction, and palliation in childhood, there is a growing number of adult patients with congenital heart disease (CHD) who may experience heart failure and subsequently require heart transplantation (HT). Because of complex anatomy, previous operations, and frequently increased pulmonary vascular resistance (PVR), these patients represent a group with a higher risk of early mortality after transplantation. METHODS: From May 1999 to December 2014, our institution performed 25 HTs in adult patients with end-stage CHD. We present our data and outcomes of transplantation in this group. RESULTS: The median age at transplantation was 38 years (range, 18.4-53.7 years). Survival was 88% at 30 days, 88% at 1 year, and 77% at 5 years. We identified long donorheart ischemic time (>4 hours) as an important risk factor for early mortality. There was no significant difference in the survival of patients undergoing transplantation for CHD and patients undergoing transplantation for other diagnoses. CONCLUSIONS: With careful donor and recipient selection, adults with end-stage CHD undergoing HT can achieve excellent early and midterm survival, comparable to the survival of patients who undergo transplantation for other diagnoses.
Authors: Paul C Tang; Xiaoting Wu; Min Zhang; Donald Likosky; Jonathan W Haft; Ienglam Lei; Ashraf Abou El Ela; Ming-Sing Si; Keith D Aaronson; Francis D Pagani Journal: J Card Surg Date: 2022-04-30 Impact factor: 1.778