Resultados a corto y largo plazo tras trasplante cardíaco en pacientes con cardiopatías congénitas

Introduction and objectives

Survival and the need for transplantation in patients with congenital heart disease have increased. This study aims to understand the perioperative characteristics and long-term survival of these patients after transplantation and to compare them with those of patients with non-congenital heart disease.

Methods

Patients who underwent a heart transplant at our center from 1984 to 2023 were included. A retrospective cohort study (congenital/non-congenital) with long-term follow-up was conducted. Statistical analysis was performed using Stata.

Results

A total of 636 transplanted patients were included, of which 37 had congenital heart disease. The number of transplanted patients with congenital heart disease has increased; 59.5% of such patients was transplanted in the last 10 years. The most frequent congenital heart disease was the transposition of great arteries. Transplanted patients with congenital heart diseases were younger, had fewer comorbidities, and a higher number of previous interventions (P < .05). There were no significant differences in extracorporeal circulation time, reoperation for bleeding, or hospital stay. The survival rates for the congenital group were 97.1%, 90.1%, 75.3%, and 52.6% at 1, 5, 10, and 20 years, respectively. Compared to the non-congenital group, congenital patients had significantly higher survival rates (HR: 0.44; 95% CI: 0.22-0.9; P = .024).

Conclusions

The number of congenital heart disease patients requiring transplantation is growing sharply. Despite their greater complexity, these patients have similar surgical outcomes and better long-term survival. Team planning and preparation will be crucial.