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Long-term results of heart transplantation for end-stage valvular heart disease

Yanto Sandy Tjang1, Geert J M G van der Heijden, Gero Tenderich

  • 1Julius Center for Health Sciences & Primary Care, University Medical Center Utrecht, The Netherlands. ystjang@hotmail.com

Journal of Cardiac Surgery
|September 11, 2009
PubMed

Insights

Heart transplantation for end-stage valvular heart disease shows similar outcomes to other indications. Longer waiting times for heart transplantation are associated with improved patient survival, suggesting a benefit for extended অপেক্ষা periods.

Area of Science:

  • Cardiology
  • Transplantation Medicine
  • Cardiac Surgery

Background:

  • Heart transplantation generally improves survival for heart failure patients.
  • Outcomes for heart transplantation in end-stage valvular heart disease (VHD) are less documented.
  • Patients with end-stage VHD often have prior cardiac surgery, potentially indicating a poorer prognosis.

Purpose of the Study:

  • To report on the outcomes of heart transplantation specifically for patients with end-stage valvular heart disease.
  • To compare these outcomes with heart transplantation for other indications.

Main Methods:

  • A retrospective analysis of 75 adult heart transplantations for end-stage VHD performed between March 1989 and December 2004.
  • Clinical data were collected from a computerized database.

Main Results:

  • Early mortality was 13% for end-stage VHD, slightly higher than the 8% for other indications (p=0.12).
  • Leading causes of early death included rejection and right ventricular failure.
  • Late mortality was 55/1000 patient-years, primarily due to infection and multiorgan failure.
  • Increased waiting time for transplantation correlated with improved survival (HR=0.998, p=0.04).
  • Survival rates at 1, 5, 10, and 15 years were 70%, 64%, 56%, and 46% for VHD patients.

Conclusions:

  • Heart transplantation outcomes for end-stage VHD are comparable to those for other indications.
  • Extended waiting times for heart transplantation appear to be associated with better patient outcomes.
Abstract

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