|Title:||Case Series: Heart Transplantation after Fontan Operation - Single-Center Experience||Authors:||Lin S.-N.
|Issue Date:||2016||Publisher:||Elsevier USA||Journal Volume:||48||Journal Issue:||3||Start page/Pages:||959-964||Source:||Transplantation Proceedings||Abstract:||
Background Fontan failure (FF) occurs rarely. In patients with Fontan failure, heart transplantation is believed to be the most effective therapy. We review our experience in heart transplantations after the Fontan operation. Methods From July 1987 to December 2014, 4 of 513 patients underwent orthotopic heart transplantation (OHT). Among them, 4 were due to FF. We reviewed these 4 cases via retrospective chart review. Clinical history, laboratory data, surgical technique, perioperative variables, and outcomes of long-term follow-up are presented herein. The primary outcomes were hospital mortality, 1-year-survival rate, and 4-year-survival rate. The secondary outcome is the improvement in patients with protein-losing enteropathy. Results The hospital mortality rate was 0% in the 4 FF patients receiving OHT. No surgically related hemorrhage or infection was observed. The 1-year-survival rate was 100% (n = 4) and the 4-year-survival rate 50% (n = 2). One patient died of posttransplantation lymphoproliferative disorder. Hypoalbuminemia improved in 1 of 3 patients 4 months after OHT. Conclusions Despite technical challenges, heart transplantation can be performed successfully in patients with Fontan operation. However, protein-losing enteropathy might not be resolved quickly after heart transplantation. ? 2016 Elsevier Inc.
|ISSN:||0041-1345||DOI:||10.1016/j.transproceed.2016.01.037||metadata.dc.subject.other:||adolescent; antibiotic therapy; Article; artificial ventilation; assisted circulation; cardiopulmonary bypass; case study; child; clinical article; disease course; electron beam tomography; female; fenestration; follow up; Fontan procedure; great vessels transposition; heart catheterization; heart function; heart left ventricle contractility; heart left ventricle ejection fraction; heart transplantation; hospital mortality; human; hypoalbuminemia; lymphoproliferative disease; maintenance therapy; male; palliative therapy; positive end expiratory pressure; pressure gradient; priority journal; protein losing gastroenteropathy; school child; sternotomy; survival rate; tricuspid valve regurgitation; adverse effects; case report; Fontan procedure; Heart Defects, Congenital; mortality; reoperation; retrospective study; time factor; treatment outcome; trends; Adolescent; Child; Female; Follow-Up Studies; Fontan Procedure; Heart Defects, Congenital; Heart Transplantation; Hospital Mortality; Humans; Male; Reoperation; Retrospective Studies; Survival Rate; Time Factors; Treatment Outcome
|Appears in Collections:||醫學系|
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