Pradegan Nicola, Cattapan Claudia, Tessari Chiara, Toscano Giuseppe, D'Onofrio Augusto, Tarzia Vincenzo, Gambino Antonio, Fedrigo Marny, Vida Vladimiro L, Angelini Annalisa, Gerosa Gino
From the Cardiac Surgery Unit, Cardio-Thoraco-Vascular and Public Health Department, Padova University Hospital, Padova, Italy.
Cardiovascular Pathology, Cardio-Thoraco-Vascular and Public Health Department, Padova University Hospital, Padova, Italy.
ASAIO J. 2025 Jul 1;71(7):e107-e109. doi: 10.1097/MAT.0000000000002353. Epub 2024 Nov 25.
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).
需要心脏移植（HT）的成年先天性心脏病（ACHD）患者通常具有复杂的解剖结构，给手术带来挑战。因此，我们分析了ACHD患者HT期间进行额外手术修复的技术方面以及早期和长期结果。共纳入40例患者（23例男性，中位年龄：38岁，四分位间距[IQR]：26 - 50）。其中，17例（42.5%）需要额外的手术修复（7例体静脉修复，13例肺动脉修复）。这些手术与单心室生理（p < 0.001）和既往Fontan姑息治疗（p < 0.001）的相关性更高。8例（20.0%）患者在30天内死亡。中位随访5.6（IQR：2.0 - 11.9）年时，5例（12.5%）患者死亡。额外的手术修复不影响术后30天和长期随访死亡率（分别为p = 0.451和p = 0.330）。
