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Long‐Term Results of Heart Transplantation for End‐Stage Valvular Heart Disease
Author(s) -
Tjang Yanto Sandy,
Heijden Geert J. M. G. van der,
Tenderich Gero,
Körfer Reiner,
Grobbee Diederick E.
Publication year - 2009
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/j.1540-8191.2009.00870.x
Subject(s) - medicine , heart transplantation , valvular heart disease , transplantation , heart failure , cardiology , heart disease , stage (stratigraphy) , heart valve , surgery , paleontology , biology
Background: In general, heart transplantation for patients with heart failure improves survival. However, the outcomes of heart transplantation for patients with end‐stage valvular heart disease are less well reported. This is a substantial group of patients, many of whom have had previous cardiac surgery. They therefore may be considered a subgroup with a poor prognosis. This study reports on the outcomes of heart transplantation for patients with end‐stage valvular heart disease. Patients and methods: From March 1989 to December 2004, 75 consecutive adult heart transplantations were performed for end‐stage valvular heart disease. Clinical characteristics were retrieved from a computerized database. Results: The early mortality risk in heart transplantation for end‐stage valvular heart disease was 13%, compared to 8% for other indications (p = 0.12). The main causes of early death were rejection (20%) and right ventricular failure (20%). The total follow‐up time was 415 patient‐years. During the follow‐up, another 23 patients died (55/1000 patient‐years of late mortality rate), mostly due to infection (43%) and multiorgan failure (22%). Multivariable analysis demonstrated that increased waiting time to heart transplantation correlated with increased survival (HR = 0.998, p = 0.04). The survival at 1, 5, 10, and 15 years was 70%, 64%, 56%, and 46% compared to 78%, 68%, 53%, and 41% for other indications, respectively (p = 0.5). Conclusion: The outcomes of heart transplantation for patients with end‐stage valvular heart disease are similar to those for other patients. Apparently, the longer the waiting time to heart transplantation the better the outcome becomes.