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Transplantation for complex congenital heart disease in adults: a subanalysis of the S panish H eart T ransplant R egistry

2012; Wiley; Volume: 26; Issue: 5 Linguagem: Inglês

10.1111/j.1399-0012.2012.01611.x

1399-0012

María Jesús Paniagua Martín, Luís Almenar, V. Brossa, María G. Crespo‐Leiro, Javier Segovia, Jesús Palomo, Juan F. Delgado, Francisco González‐Vílchez, Nicolás Manito, E. Lage, Luis García‐Guereta, José L. Rodríguez‐Lambert, Dimpna C. Albert,

Cardiac Structural Anomalies and Repair

Abstract Background Congenital heart diseases ( CHD s) have high infant mortality in their severe forms. When adulthood is reached, a heart transplant ( HT x) may be required. Spanish adult population transplanted for CHD was analyzed and compared with the most frequent causes of HT x and between different subgroups of CHD . Materials and Methods A total of 6048 patients ( HT x 1984–2009) were included. Pediatric transplants (<15 yr), combined transplants, re HT x, and HT x for heart diseases other than idiopathic dilated cardiomyopathy ( IDCM ) and ischemic heart disease ( IHD ) were excluded. Total patients included: 3166 ( IHD = 1888; IDCM = 1223; CHD = 55). Subgroups were studied as follows: (1) single ventricle with pulmonary stenosis (n = 18), (2) single ventricle with tricuspid atresia and G lenn/ F ontan surgery (n = 10), (3) congenitally corrected transposition of the great vessels ( TGV ) or with switch atrial surgery (n = 10), and (4) CHD with right ventricle overload (n = 17). Results Survival probability was different between groups (p = 0.0001). Post hoc analysis showed some differences between groups ( CHD vs. IHD , p = 0.05; CHD vs. IDCM , p = 0.5; IHD vs. IDCM , p = 0.0001). Early mortality was different between CHD subgroups (group 1 = 19%, group 2 = 40%, group 3 = 0%, group 4 = 29%; p < 0.001); however, overall mortality did not show differences between subgroups (p = 0.5). Conclusions The percentage of S panish adult HT x patients for CHD is low (1%). The survival curve is better than for other HT x causes ( IHD ). Nevertheless, early mortality was higher, particularly in some subgroups ( F ontan).