Short-Term Survival Worse for Single-Ventricle Congenital Heart Disease Patients

MONDAY, Sept. 25, 2023 (HealthDay News) -- Single-ventricle congenital heart disease (CHD) patients undergoing heart transplant have worse short-term survival, according to a study published online in the Sept. 19 issue of the Journal of the American College of Cardiology.

Syed Shahyan Bakhtiyar, M.D., from the David Geffen School of Medicine at the University of California in Los Angeles, and colleagues conducted a 15-year retrospective analysis to assess survival after heart transplantation in adults with single-ventricle and biventricular CHD compared with non-CHD transplant recipients.

The researchers found that 48 percent of the 382 adult heart transplant recipients with CHD had single-ventricle physiology. Single-ventricle versus biventricular CHD patients showed significantly reduced survival at one year (80 versus 91 percent; hazard ratio [HR], 2.50; 95 percent confidence interval [CI], 1.40 to 4.49) and 10 years (54 versus 71 percent; HR, 2.10; 95 percent CI, 1.38 to 3.18). Among patients who survived the first posttransplantation year, 10-year survival was similar for biventricular versus single-ventricle CHD patients, except those with hypoplastic left heart syndrome (79 versus 71 percent; HR, 1.58; 95 percent CI, 0.85 to 2.92; P = 0.15). Compared with their non-CHD counterparts, biventricular CHD transplant recipients showed significantly better 10-year conditional survival (79 versus 68 percent; HR, 0.73; 95 percent CI, 0.59 to 0.90).

"These findings carry significant implications towards patient selection and listing strategies, as they not only alleviate concerns associated with heart transplantation in adults with CHD, but also work towards destigmatizing most subtypes of single-ventricle CHD," the authors write.

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