Division of Cardiology, Heart Failure, Heart Transplantation, and Pulmonary Hypertension Programs, University of California, San Francisco, CA, USA.
Prog Cardiovasc Dis. 2011 Jan-Feb;53(4):312-23. doi: 10.1016/j.pcad.2010.12.002.
Considerable progress in pediatric cardiac surgery has led to more patients with congenital heart disease surviving into adulthood. However, progressive cardiopulmonary dysfunction often occurs late after palliative or corrective surgeries to the point where transplantation becomes the only treatment option. Adult congenital heart disease represents a growing population of patients being referred for heart, lung, and combined heart-lung transplantation. This group of patients presents multiple unique surgical and medical challenges to transplantation owing to their complex anatomy, multiple prior palliative and corrective procedures, frequently increased pulmonary vascular resistance, and often debilitated condition. Consequently, transplantation in adults with congenital heart disease is associated with a relatively high operative mortality secondary to increased bleeding, infection, and graft failure rates compared with noncongenital heart disease transplant recipients. However, those who survive of the first posttransplant year enjoy an excellent long-term prognosis.
在儿科心脏外科学方面取得的重大进展使得更多患有先天性心脏病的患者能够存活至成年。然而，在姑息性或矫正手术后，心肺功能障碍常常会逐渐加重，以至于移植成为唯一的治疗选择。成人先天性心脏病患者数量不断增加，他们需要进行心肺移植或心脏-肺联合移植。由于这类患者的解剖结构复杂，曾多次接受姑息性和矫正手术，肺血管阻力通常较高，且身体状况常常较差，因此与非先天性心脏病移植受者相比，他们在接受移植时会面临更多独特的手术和医疗挑战。因此，与非先天性心脏病移植受者相比，成人先天性心脏病患者的移植手术相关死亡率较高，这主要与术中出血、感染和移植物衰竭发生率较高有关。但是，那些在移植后第一年存活下来的患者长期预后良好。
