부산대학교 도서관

Background Congenital heart diseases ( CHDs) have high infant mortality in their severe forms. When adulthood is reached, a heart transplant ( HTx) may be required. Spanish adult population transplanted for CHD was analyzed and compared with the most frequent causes of HTx and between different subgroups of CHD. Materials and Methods A total of 6048 patients ( HTx 1984-2009) were included. Pediatric transplants (<15 yr), combined transplants, re HTx, and HTx for heart diseases other than idiopathic dilated cardiomyopathy ( IDCM) and ischemic heart disease ( IHD) were excluded. Total patients included: 3166 ( IHD = 1888; IDCM = 1223; CHD = 55). Subgroups were studied as follows: (1) single ventricle with pulmonary stenosis (n = 18), (2) single ventricle with tricuspid atresia and Glenn/ Fontan surgery (n = 10), (3) congenitally corrected transposition of the great vessels ( TGV) or with switch atrial surgery (n = 10), and (4) CHD with right ventricle overload (n = 17). Results Survival probability was different between groups (p = 0.0001). Post hoc analysis showed some differences between groups ( CHD vs. IHD, p = 0.05; CHD vs. IDCM, p = 0.5; IHD vs. IDCM, p = 0.0001). Early mortality was different between CHD subgroups (group 1 = 19%, group 2 = 40%, group 3 = 0%, group 4 = 29%; p < 0.001); however, overall mortality did not show differences between subgroups (p = 0.5). Conclusions The percentage of Spanish adult HTx patients for CHD is low (1%). The survival curve is better than for other HTx causes ( IHD). Nevertheless, early mortality was higher, particularly in some subgroups ( Fontan). [ABSTRACT FROM AUTHOR]