Heart Transplantation in Patients with Superior Vena Cava to Pulmonary Artery Anastomosis: A Single-Institution Experience
The Korean Journal of Thoracic and Cardiovascular Surgery
;
: 167-171, 2018.
Article
in English
| WPRIM
| ID: wpr-715415
ABSTRACT
BACKGROUND:
Heart transplantation (HTx) can be a life-saving procedure for patients in whom single ventricle palliation or one-and-a-half (1½) ventricle repair has failed. However, the presence of a previous bidirectional cavopulmonary shunt (BCS) necessitates extensive pulmonary artery angioplasty, which may lead to worse outcomes. We sought to assess the post-HTx outcomes in patients with a previous BCS, and to assess the technical feasibility of leaving the BCS in place during HTx.METHODS:
From 1992 to 2017, 11 HTx were performed in patients failing from Fontan (n=7), BCS (n=3), or 1½ ventricle (n=1) physiology at Asan Medical Center. The median age at HTx was 12.0 years (range, 3–24 years). Three patients (27.3%) underwent HTx without taking down the previous BCS.RESULTS:
No early mortality was observed. One patient died of acute rejection 3.5 years after HTx. The overall survival rate was 91% at 2 years. In the 3 patients without BCS take-down, the median anastomosis time was 65 minutes (range, 54–68 minutes), which was shorter than in the patients with BCS take-down (93 minutes; range, 62–128 minutes), while the postoperative central venous pressure (CVP) was comparable to the preoperative CVP.CONCLUSION:
Transplantation can be successfully performed in patients with end-stage congenital heart disease after single ventricle palliation or 1½ ventricle repair. Leaving the BCS in place during HTx may simplify the operative procedure without causing significant adverse outcomes.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Physiology
/
Pulmonary Artery
/
Surgical Procedures, Operative
/
Vena Cava, Superior
/
Central Venous Pressure
/
Survival Rate
/
Mortality
/
Heart Transplantation
/
Angioplasty
/
Fontan Procedure
Type of study:
Prognostic study
Limits:
Humans
Language:
English
Journal:
The Korean Journal of Thoracic and Cardiovascular Surgery
Year:
2018
Type:
Article
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