The purpose of this study was to review the clinical course and outcome of cardiac transplantation after a failed Glenn or Fontan procedure. Late complications of the Glenn or Fontan procedure, including ventricular failure, cyanosis, protein-losing enteropathy, thromboembolism, and dysrhythmias often lead to significant morbidity and mortality. If other therapies are ineffective, cardiac transplantation is the only therapeutic recourse. Transplantation in this unique population presents significant challenges in the operative and perioperative periods. The anatomic diagnoses, previous operations, clinical status, and indications for transplantation were characterized in patients transplanted after a Glenn or Fontan procedure. Outcomes after transplantation, including postoperative complications and mortality, were reviewed. Comparisons were made between survivors and nonsurvivors. Primary orthotopic cardiac transplantation was performed in 35 patients (mean age 15.7 +/- 8.5 years) with a mean follow-up of 54 +/- 46 months. A total of 11 patients had undergone a Glenn shunt and 24 patients a Fontan procedure. Indications for transplantation were a combination of causes including ventricular dysfunction, failed Fontan physiology...Continue Reading
Expanding applicability of transplantation after multiple prior palliative procedures. The Paediatric Heart Transplant Group
Early and intermediate-term (10-year) results of surgery for univentricular atrioventricular connection ("single ventricle")
Prevalence and risk factors for aortopulmonary collateral vessels after Fontan and bidirectional Glenn procedures
Long-term survivors of pediatric heart transplantation: a multicenter report of sixty-eight children who have survived longer than five years
Protein-losing enteropathy after the Fontan operation: an international multicenter study. PLE study group
Results after Norwood procedure and subsequent cavopulmonary anastomoses for typical hypoplastic left heart syndrome and similar complex cardiovascular malformations
The Registry of the International Society for Heart and Lung Transplantation: Fifth Official Pediatric Report-2001 to 2002
Orthotopic heart transplantation for congenital heart disease: an alternative for high-risk fontan candidates?
2008 Riley Heart Center Symposium on cardiac development: growth and morphogenesis of the ventricular wall
Numerical and experimental investigation of pulsatile hemodynamics in the total cavopulmonary connection
Canadian Cardiovascular Society 2009 Consensus Conference on the management of adults with congenital heart disease: complex congenital cardiac lesions
Protein-losing enteropathy: integrating a new disease paradigm into recommendations for prevention and treatment
Congenital heart disease in the adult: a review with internet-accessible transesophageal echocardiographic images
Organ allocation in adults with congenital heart disease listed for heart transplant: impact of ventricular assist devices
Surgical strategies to facilitate heart transplantation in children after failed univentricular palliations: the role of advanced intraoperative surgical preparation
Heart Transplantation in Adults With Congenital Heart Disease: 100% Survival With Operations Performed by a Surgeon Specializing in Congenital Heart Disease in an Adult Hospital
Advanced therapies for congenital heart disease: ventricular assist devices and heart transplantation
Frequency of superior vena cava obstruction in pediatric heart transplant recipients and its relation to previous superior cavopulmonary anastomosis
Comparison of risk factors and outcomes for pediatric patients listed for heart transplantation after bidirectional Glenn and after Fontan: an analysis from the Pediatric Heart Transplant Study
The Fontan procedure: evolution in technique; attendant imperfections and transplantation for "failure"
Heart transplantation in adolescent and adult patients with congenital heart disease: a case-control study
Late outcomes of pediatric heart transplantation are independent of pre-transplant diagnosis and prior cardiac surgical intervention
Detection of TUNEL-positive cardiomyocytes and c-kit-positive progenitor cells in children with congenital heart disease
Transplantation for complex congenital heart disease in adults: a subanalysis of the Spanish Heart Transplant Registry
Treatment planning for a TCPC test case: a numerical investigation under rigid and moving wall assumptions
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