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Characteristics and Outcomes of a Single-Centre Cohort of Adult Congenital Heart Disease Patients Referred for Heart Transplant.
Jayadeva, Pavithra S; Peters, Stacey; Tee, Su Ling; Burchill, Luke J; Marasco, Silvana F; Grigg, Leeanne; Leet, Angeline; McGiffin, David; Zentner, Dominica.
Afiliação
  • Jayadeva PS; Department of Cardiology, Royal Melbourne Hospital, Melbourne, Vic, Australia. Electronic address: pavjayadeva@gmail.com.
  • Peters S; Department of Cardiology, Royal Melbourne Hospital, Melbourne, Vic, Australia.
  • Tee SL; Department of Cardiology and Cardiothoracic Surgery, Alfred Hospital, Vic, Australia.
  • Burchill LJ; Department of Cardiology, Mayo Clinic, Rochester, MN, USA.
  • Marasco SF; Department of Cardiology and Cardiothoracic Surgery, Alfred Hospital, Vic, Australia.
  • Grigg L; Department of Cardiology, Royal Melbourne Hospital, Melbourne, Vic, Australia.
  • Leet A; Department of Cardiology and Cardiothoracic Surgery, Alfred Hospital, Vic, Australia.
  • McGiffin D; Department of Cardiology and Cardiothoracic Surgery, Alfred Hospital, Vic, Australia.
  • Zentner D; Department of Cardiology, Royal Melbourne Hospital, Melbourne, Vic, Australia.
Heart Lung Circ ; 33(8): 1184-1192, 2024 Aug.
Article em En | MEDLINE | ID: mdl-38609798
ABSTRACT

BACKGROUND:

Adult congenital heart disease (ACHD) services increasingly encounter heart failure (HF) in the ageing ACHD population. Optimal timing of referral for heart transplant (HTx) evaluation in this heterogeneous population is complex and ill-defined. We aim to outline the characteristics and outcomes of ACHD patients referred for HTx from a large Australian ACHD centre.

METHOD:

Retrospective review of ACHD patients referred for HTx from a primary ACHD centre (1992-2021). Database analysis of patient demographics, characteristics, wait-listing, and transplantation outcomes was performed.

RESULTS:

A total of 45 patients (mean age 37±9.9 years old; 69% male) were referred for HTx with a mean follow-up of 5.9±6.3 years. Of these, 22 of 45 (49%) were listed and transplanted, including one heart-lung transplant. The commonest diagnosis was dextro-transposition of the great arteries (13/45, 29%). Most patients, 33 of 45 (73.3%) had undergone at least one cardiac surgery in childhood. Indications for HTx referral included HF in 34 of 45 (75%), followed by pulmonary hypertension in 7 of 45 (11%). Median transplant wait-list time was 145 days (interquartile range, 112-256). Of the 23 patients not wait-listed, the reasons included clinical stability in 13 of 45 (29%), psychosocial factors in 2 of 45 (4.4%) and prohibitive surgical risk, including multiorgan dysfunction, in 8 of 45 (17.7%). Transplant was of a single organ in most, 21 of 22 (95.5%). Overall mortality was 5 of 22 (22.7%) in those after HTx, and 14 of 23 (60.9%) in those not listed (p=0.0156).

CONCLUSIONS:

Increasingly, ACHD patients demonstrate the need for advanced HF treatments. HTx decision-making is complex, and increased mortality is seen in those not wait-listed. Ultimately, the referral of ACHD patients for HTx is underpinned by local decision-making and experience, wait-list times and outcomes.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Encaminhamento e Consulta / Listas de Espera / Transplante de Coração / Cardiopatias Congênitas Limite: Adult / Female / Humans / Male / Middle aged País/Região como assunto: Oceania Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Encaminhamento e Consulta / Listas de Espera / Transplante de Coração / Cardiopatias Congênitas Limite: Adult / Female / Humans / Male / Middle aged País/Região como assunto: Oceania Idioma: En Ano de publicação: 2024 Tipo de documento: Article