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Updated: Dec 28, 2025
Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
Transplantation in Congenital Heart Disease: A Challenge
Nora Palomo-López1, Sara Escalona-Rodríguez1, Luis Martín-Villén2
1Intensive Care Unit, University Hospital Virgen del Rocío, Seville, Spain.
Insights
Heart transplantation (OHT) is a viable treatment for grown-up congenital heart disease (GUCH) patients with heart failure. This study shows OHT offers good survival rates for GUCH patients, despite potential complications.
Area of Science:
- Cardiology
- Transplantation Medicine
- Congenital Heart Disease
Background:
- Heart failure is a primary cause of mortality in grown-up congenital heart disease (GUCH) patients.
- Heart transplantation (OHT) is the optimal treatment for end-stage heart failure, yet its application in GUCH is infrequent.
Purpose of the Study:
- To characterize the cohort of GUCH patients who underwent OHT at a tertiary care center.
- To analyze the outcomes and survival rates of GUCH patients post-OHT.
Main Methods:
- Retrospective review of GUCH patients undergoing OHT from 1997 to 2019.
- Inclusion of preoperative (demographics, clinical data, hemodynamics) and postoperative variables (complications, survival).
Main Results:
- Fourteen GUCH patients (median age 25.5 years) underwent OHT.
- Post-OHT complications included infection (42.9%), renal replacement therapy (28.6%), liver failure (28.6%), and graft failure (28.6%).
- Overall survival rate was 78.6%, with 50% survival for patients requiring extracorporeal membrane oxygenation.
Conclusions:
- OHT is a beneficial therapeutic option for GUCH patients with advanced heart failure.
- Despite significant postoperative complications, OHT demonstrates favorable long-term survival in this population.
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.
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