Complex Congenital Heart Disease: Is Heart Transplantation an Option?

Area of Science:

• Cardiology
• Transplantation Medicine
• Congenital Heart Disease

Background:

• Congenital heart disease (CHD) is an infrequent underlying condition in heart transplant (HT) recipients.
• This study focuses on the complications and outcomes of CHD patients undergoing HT.

Purpose of the Study:

• To assess the complications and follow-up of patients with congenital heart disease (CHD) who underwent heart transplantation (HT).

Main Methods:

• Retrospective analysis of patients over 14 years old with CHD and HT.
• Evaluation of clinical and surgical variables.

Main Results:

• Ten CHD patients (2.2% of total HT series) were analyzed, younger than other HT recipients (median age 25 vs 53).
• CHD patients had significantly more prior cardiac surgeries (100% vs 14.4%) and fewer cardiovascular risk factors (0% vs 60%).
• Left ventricle ejection fraction differed significantly between groups; primary graft failure was more common in CHD patients.

Conclusions:

• Heart transplant recipients with CHD represent a distinct subgroup with unique comorbidities and pre-transplant profiles.
• These patients experience more complex postoperative courses, including longer extracorporeal circulation, intubation, and ICU stays.
• Despite initial challenges and lower 1-month survival, long-term survival in CHD patients after HT is comparable, supporting HT as a viable option.