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Transplantation in Congenital Heart Disease: A Challenge.

Abstract：

BACKGROUND:Heart failure is the leading cause of death in grown-up congenital heart disease patients (GUCH). Although heart transplantation (OHT) remains the gold standard in end-stage heart failure, the ratio of GUCH patients undergoing this procedure remains low. OBJECTIVE:Describe the cohort of GUCH patients undergoing heart transplantation at a third-level hospital. METHODS:A retrospective review of GUCH patients undergoing OHT between 1997 and 2019 was conducted at a single tertiary university hospital. We included different preoperative (demographic and clinical data, cardiac catheterization data from the last routine hemodynamic monitoring) and postoperative variables (complications, survival). RESULTS:Fourteen patients were enrolled. The median age was 25.5 years (range, 20.7-32.2). Eight patients (57.1%) were male. The median preoperative left ventricular ejection fraction was 37% (range, 22.5%-55%). As for preoperative hemodynamic evaluation, the median for the mean arterial pulmonary pressure was 19 mm Hg (range, 12-22.5), for the capillary wedge pressure was 16 mm Hg (range, 13.5-19.5), and for pulmonary vascular resistance was 1.83 Wood units (range, 1-4). After OHT, 6 patients (42.9%) suffered an infection, the most common of which was respiratory (3 out of 6). Four patients (28.6%) needed renal replacement therapy, and 4 patients (28.6%) presented liver failure. Four patients (28.6%) developed graft failure, thus requiring mechanical support with extracorporeal membrane oxygenation during a median of 6 days (range, 1-17.5). Survival rate of patients under extracorporeal membrane oxygenation was 50%, and overall survival rate was 78.6%. CONCLUSION:OHT represents a good option for GUCH patients, with good overall survival rates.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Palomo-López N,Escalona-Rodríguez S,Martín-Villén L,Herruzo-Avilés Á,Hinojosa-Pérez R,Escoresca-Ortega A,Porras-López M,Corcia-Palomo Y,Adsuar-Gómez A

doi

10.1016/j.transproceed.2019.12.027

subject

Has Abstract

pub_date

2020-03-01 00:00:00

pages

577-579

issue

2

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(19)31223-0

journal_volume

52

pub_type

杂志文章

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