Anatomical Aspects and Long-Term Outcomes of Additional Surgical Repair During Heart Transplantation in Adult Congenital Heart Disease

Nicola Pradegan; Claudia Cattapan; Chiara Tessari; Giuseppe Toscano; Augusto D'Onofrio; Vincenzo Tarzia; Antonio Gambino; Marny Fedrigo; Vladimiro L Vida; Annalisa Angelini; Gino Gerosa

doi:10.1097/MAT.0000000000002353

Anatomical Aspects and Long-Term Outcomes of Additional Surgical Repair During Heart Transplantation in Adult Congenital Heart Disease

ASAIO J. 2024 Nov 26. doi: 10.1097/MAT.0000000000002353. Online ahead of print.

Affiliations

¹ From the Cardiac Surgery Unit, Cardio-Thoraco-Vascular and Public Health Department, Padova University Hospital, Padova, Italy.
² Cardiovascular Pathology, Cardio-Thoraco-Vascular and Public Health Department, Padova University Hospital, Padova, Italy.
³ Pediatric Cardiac Surgery Unit, Cardio-Thoraco-Vascular and Public Health Department, Padova University Hospital, Padova, Italy.

PMID: 39773761
DOI: 10.1097/MAT.0000000000002353

Abstract

Adult patients with congenital heart disease (ACHD) requiring heart transplantation (HT) usually show complex anatomies, posing surgical challenges. Consequently, we analyzed technical aspects and early and long-term outcomes of additional surgical repairs during HT in ACHD. Forty patients were identified (23 males, median age: 38 years, interquartile range [IQR]: 26-50). Of these, 17 (42.5%) required additional surgical repair (7 systemic veins repair, 13 pulmonary arteries repair). These procedures were more associated with univentricular physiology (p < 0.001) and prior Fontan palliation (p < 0.001). Eight (20.0%) experienced 30 day mortality. At a median follow-up of 5.6 (IQR: 2.0-11.9) years, 5 (12.5%) patients died. Additional surgical repair did not affect postoperative 30 day and long-term follow-up mortality (p = 0.451 and p = 0.330, respectively).