Impact on Survival of Heart and Heart-Lung Transplantation in Patients With Cyanotic and Noncyanotic Congenital Heart Diseases

Background. A high percentage of patients with congenital heart diseases (CHD) reach adulthood and, over time, require heart transplantation (HTx) or combined heart-lung transplantation (HLTx). Among CHD, there are subgroups associated with a higher risk. Methods. Retrospective analysis of HTx and HLTx in CHD patients. They are subdivided based on the etiology of cyanotic or noncyanotic CHD. Baseline characteristics and mortality are comparatively analyzed. No comparative analysis is performed between HTx and HLTx. Results. A total of 1015 HTx were performed, 933 (91,9%) were first-time HTx, and 42 (4.1%) were HLTx. Of the HTx, 18 (1.8%) were in CHD patients. In the HLTx group, 18 (42.8%) had CHD. In the HTx group, cyanotic patients had fewer surgical interventions (57% vs. 18%), compared to noncyanotic patients, where corrective surgeries were more common. Cyanotic patients had a higher mortality rate (57.1% vs. 18.2%), and their median survival was slightly lower (15.9 vs. 16.7 years). In the HLTx group, ninety percent of cyanotic patients had no previous surgeries, compared to 25% in the other group. The mortality rate was higher in cyanotic patients (60% vs. 37.5%), and their median survival was lower (1.7 vs. 9.5 years). Mortality occurred mainly in the first 30 days and was higher in cyanotic patients. Conclusions. In CHD patients following HTx or HLTx, cyanotic conditions are associated with lower survival, with higher mortality occurring during the first 30 days.