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Prog Cardiovasc Dis. 2011 Jan-Feb;53(4):312-23. doi: 10.1016/j.pcad.2010.12.002.

Transplantation in adults with congenital heart disease.

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  • 1Division of Cardiology, Heart Failure, Heart Transplantation, and Pulmonary Hypertension Programs, University of California, San Francisco, CA, USA.


Considerable progress in pediatric cardiac surgery has led to more patients with congenital heart disease surviving into adulthood. However, progressive cardiopulmonary dysfunction often occurs late after palliative or corrective surgeries to the point where transplantation becomes the only treatment option. Adult congenital heart disease represents a growing population of patients being referred for heart, lung, and combined heart-lung transplantation. This group of patients presents multiple unique surgical and medical challenges to transplantation owing to their complex anatomy, multiple prior palliative and corrective procedures, frequently increased pulmonary vascular resistance, and often debilitated condition. Consequently, transplantation in adults with congenital heart disease is associated with a relatively high operative mortality secondary to increased bleeding, infection, and graft failure rates compared with noncongenital heart disease transplant recipients. However, those who survive of the first posttransplant year enjoy an excellent long-term prognosis.

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