Original article: cardiovascularTrends and Outcomes in Transplantation for Complex Congenital Heart Disease: 1984 to 2004
Section snippets
Patient Population
A retrospective review was performed to evaluate all patients undergoing cardiac transplantation at the Columbia University Medical Center between January 1, 1984 and January 1, 2004. A total of 1,525 (1,151 male, 374 female) patients comprised this cohort, of whom 106 were patients transplanted with complex congenital heart disease; these patients form the basis of the current analysis of outcomes.
Hospital chart review was conducted on each identified patient and their donor, and the data
Results
Patient characteristics are shown in Table 1. Available follow-up in these patients ranged from 0 to 233.2 months (including patients who died immediately postoperatively) with a median of 56 months. Mantel-Haenszel χ2 analysis of patients grouped by age, and analyzed by era, demonstrated increased mortality with younger age (p = 0.044), particularly in the early era (p = 0.021). Cardiopulmonary bypass time, aortic cross-clamp time, and donor heart ischemic times were mean (range),
Comment
Orthotopic heart transplantation has evolved over the past four decades to become a standard treatment for neonates, children, and adults with end-stage heart disease. While significant advances have been made in the surgical repair and postoperative management of patients with complex congenital heart disease, transplantation still remains the “final therapeutic alternative” for those patients who ultimately develop irreversible myocardial failure. Such patients with complex congenital heart
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