Department of Cardiovascular and Thoracic Surgery, University Hospital of Liège, Liège, Belgium.
Department of Cardiology, University Hospital of Liège, Liège, Belgium.
Acta Cardiol. 2023 Apr;78(2):188-194. doi: 10.1080/00015385.2021.1973773. Epub 2021 Oct 3.
Heart transplantation (HTx) in adults with congenital heart disease (ACHD) remains challenging because of structural anomalies and often previous procedure. The aim of this retrospective study was to describe the outcomes of heart transplantation (HTx) in a cohort of ACHD patients at our tertiary centre.
Between January 1993 and December 2010, 223 consecutive adult patients (age > 18 years) underwent HTx at our institution. Fifteen (6.7%) were ACHD patients. Outcomes were reviewed using our institution's HTx database. We looked at 30-day, 1, 5 and 10-years survival, as well as post-transplantation complications.
The mean age at HTx of the groups of ACHD was 42 ± 14.4 years, vs 54.2 ± 9.8 years for the non-CHD patients. Prior to transplant, thirteen of the fifteen ACHD had undergone one or more surgical procedures including palliative or corrective open-heart procedures in 66.6% of them. Seven of the fifteen ACHD (47%) required additional surgical procedures at transplantation. The mean follow-up was 95,44 ± 84.3 months. There was no significant difference in survival (ACHD vs non-CHD) at 30 days (87% vs. 90%), 1 year (73% vs. 74.5%) or 5 years (53% vs. 55%). Survival at 10 years was respectively 53% and 41% for ACHD patients and non-CHD patients.
Despite the surgical challenge, HTx in ACHD has a good long-term result. However, the small sample size of our cohort limits any definitive conclusions.
成人先天性心脏病（ACHD）患者心脏移植（HTx）仍然具有挑战性，因为存在结构异常，且往往之前接受过手术。本回顾性研究的目的是描述我们的三级中心 ACHD 患者心脏移植（HTx）的结果。
1993 年 1 月至 2010 年 12 月期间，我院共连续进行了 223 例成人 HTx，其中 15 例（6.7%）为 ACHD 患者。使用我们机构的 HTx 数据库回顾了结果。我们观察了 30 天、1 年、5 年和 10 年的生存率，以及移植后的并发症。
ACHD 组 HTx 的平均年龄为 42±14.4 岁，而非 CHD 组为 54.2±9.8 岁。在移植前，15 例 ACHD 中有 13 例接受过一次或多次手术，其中 66.6%的患者接受过姑息性或矫正性心脏直视手术。15 例 ACHD 中有 7 例（47%）在移植时需要进行额外的手术。平均随访时间为 95.44±84.3 个月。30 天（87%比 90%）、1 年（73%比 74.5%）和 5 年（53%比 55%）的生存率无显著差异。10 年生存率分别为 ACHD 患者 53%和非 CHD 患者 41%。
尽管存在手术挑战，但 ACHD 患者的 HTx 具有良好的长期结果。然而，我们的队列样本量较小，限制了任何明确的结论。
