Survival based on patient selection for heart transplant in adults with congenital heart disease: A multi-institutional study

Boucek, Dana; Yetman, Angela T; Yeung, Elizabeth; Miyamoto, Shelley D.; Stehlik, Josef; Kfoury, A.G.; Kaza, Aditya K.; Weng, Cindy; Everitt, Melanie D.

doi:10.1016/j.ijcard.2013.12.133

Cited by 9 publications

(4 citation statements)

References 5 publications

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“…12,[15][16] In a recent multicenter study, there was no waitlist mortality among adult CHD patients listed for transplant. 39 There is, however, evidence that higher risk patients, such as those 15 with single ventricle physiology, are less likely to be listed for transplant, and mortality among these patients is high after the onset of progressive heart failure. [39][40] …”

Section: Limitationsmentioning

confidence: 99%

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Outcomes in adult congenital heart disease patients undergoing heart transplantation: A systematic review and meta-analysis

Doumouras

Alba

Foroutan

et al. 2016

The Journal of Heart and Lung Transplantation

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Section: Limitationsmentioning

confidence: 99%

“…39 There is, however, evidence that higher risk patients, such as those 15 with single ventricle physiology, are less likely to be listed for transplant, and mortality among these patients is high after the onset of progressive heart failure. [39][40] …”

Section: Limitationsmentioning

confidence: 99%

Outcomes in adult congenital heart disease patients undergoing heart transplantation: A systematic review and meta-analysis

Doumouras

Alba

Foroutan

et al. 2016

The Journal of Heart and Lung Transplantation

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“…In one multi‐center study of 45 patients with ACHD referred for heart transplantation, single‐ventricle anatomy was observed in 10 of the 27 listed patients (37%) and in 13 of the 18 unlisted patients (72%) 39 . Overall, patients with ACHD comprise only 3% of adult patients undergoing cardiac transplants 40 .…”

Section: Single‐ventricle Circulation With Glenn‐ and Fontan‐type Conmentioning

confidence: 99%

Adult congenital heart disease and anesthesia: An educational review

Lei

Heggie

2020

Pediatric Anesthesia

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Prognosis has dramatically improved among children with congenital heart disease (CHD), and the median survival for severe CHD is currently 25 years (ie, into adulthood). However, additional cardiac surgeries are often necessary in adults with CHD, whose unique cardiovascular anatomy and physiology necessitate specialized management by experts in adult CHD (ACHD) during the perioperative period. ACHD is characterized by a combination of congenital cardiac lesions, intervention‐related anomalies that have developed over time, comorbidities caused by long‐standing CHD, and comorbidities related to various syndromes and lifestyle factors. The present educational review discusses the transition from pediatric to adult cardiac care, comorbidities that develop as a result of ACHD, the assessments necessary for patients with ACHD prior to both cardiac and noncardiac surgeries, and the key ACHD lesions relevant to perioperative management.

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“…Mortality among those not listed for heart transplantation was high - 11–38 (29%) died after assessment 8. In a more recent study of 45 patients with ACHD evaluated for heart transplant, 18 were deemed ineligible; 13 due to high operative risk and 5 who were considered too well 34. Those declined for transplant were more likely to have single-ventricle physiology (present in 72% of those declined vs 37% of those listed, p=0.03) with liver cirrhosis being a common concern.…”

Section: Heart Transplant Assessment: Special Considerations In Achdmentioning

confidence: 99%

Heart transplantation in adult congenital heart disease

Burchill

2016

Heart

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Heart failure (HF) in adult congenital heart disease (ACHD) is vastly different to that observed in acquired heart disease. Unlike acquired HF in which pharmacological strategies are the cornerstone for protecting and improving ventricular function, ACHD-related HF relies heavily upon structural and other interventions to achieve these aims. patients with ACHD constitute a small percentage of the total adult heart transplant population (∼3%), although the number of ACHD heart transplant recipients is growing rapidly with a 40% increase over the last two decades. The worldwide experience to date has confirmed heart transplantation as an effective life-extending treatment option in carefully selected patients with ACHD with end-stage cardiac disease. Opportunities for improving outcomes in patients with ACHD-related HF include (i) earlier recognition and referral to centres with combined expertise in ACHD and HF, (ii) increased awareness of arrhythmia and sudden cardiac death risk in this population, (iii) greater collaboration between HF and ACHD specialists at the time of heart transplant assessment, (iv) expert surgical planning to reduce ischaemic time and bleeding risk at the time of transplant, (v) tailored immunosuppression in the post-transplant period and (vi) development and validation of ACHD-specific risk scores to predict mortality and guide patient selection. The purpose of this article is to review current approaches to diagnosing and treating advanced HF in patients with ACHD including indications, contraindications and clinical outcomes after heart transplantation.

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Survival based on patient selection for heart transplant in adults with congenital heart disease: A multi-institutional study

Cited by 9 publications

References 5 publications

Outcomes in adult congenital heart disease patients undergoing heart transplantation: A systematic review and meta-analysis

Outcomes in adult congenital heart disease patients undergoing heart transplantation: A systematic review and meta-analysis

Adult congenital heart disease and anesthesia: An educational review

Heart transplantation in adult congenital heart disease

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