Impact of the operative technique on mid- and long-term results following paediatric heart transplantation.

Autor: Rosenthal LL; Division for Pediatric and Congenital Heart Surgery, Ludwig Maximilian University, Munich, Germany.; Department of Cardiac Surgery, Ludwig Maximilian University, Munich, Germany.; Munich Heart Alliance (MHA) - DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany., Grinninger C; Department of Cardiac Surgery, Ludwig Maximilian University, Munich, Germany., Pozza RD; Department of Congenital and Pediatric Herat Surgery, German Herat Center Munich, Technische Universität München, Munich, Germany., Fischer M; Department of Congenital and Pediatric Herat Surgery, German Herat Center Munich, Technische Universität München, Munich, Germany., Zimmerling L; Division for Pediatric and Congenital Heart Surgery, Ludwig Maximilian University, Munich, Germany.; Department of Cardiac Surgery, Ludwig Maximilian University, Munich, Germany., Ulrich SM; Department of Congenital and Pediatric Herat Surgery, German Herat Center Munich, Technische Universität München, Munich, Germany., Kari FA; Division for Pediatric and Congenital Heart Surgery, Ludwig Maximilian University, Munich, Germany.; Department of Cardiac Surgery, Ludwig Maximilian University, Munich, Germany.; Munich Heart Alliance (MHA) - DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany., Haas NA; Department of Congenital and Pediatric Herat Surgery, German Herat Center Munich, Technische Universität München, Munich, Germany., Michel S; Division for Pediatric and Congenital Heart Surgery, Ludwig Maximilian University, Munich, Germany.; Department of Cardiac Surgery, Ludwig Maximilian University, Munich, Germany.; Munich Heart Alliance (MHA) - DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany., Hörer J; Division for Pediatric and Congenital Heart Surgery, Ludwig Maximilian University, Munich, Germany.; Munich Heart Alliance (MHA) - DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany., Hagl C; Department of Cardiac Surgery, Ludwig Maximilian University, Munich, Germany.; Department for Pediatric Cardiology and Intensive Care, Ludwig Maximilian University, Munich, Germany.
Jazyk: angličtina
Zdroj: ESC heart failure [ESC Heart Fail] 2024 Jun; Vol. 11 (3), pp. 1602-1611. Date of Electronic Publication: 2024 Feb 20.
DOI: 10.1002/ehf2.14718
Abstrakt: Aims: The aim of this study is to evaluate and compare the impact of the bicaval technique versus the biatrial technique (by Lower and Shumway) in paediatric heart transplant patients. Only a few studies investigate this matter regarding the long-term outcome after paediatric heart transplantation. We compared the two surgical methods regarding survival, the necessity of pacemaker implantation.
Methods and Results: All 134 patients (aged <18 years) - (group-1) biatrial (n = 84), versus (group-2) bicaval (n = 50), who underwent heart transplantation between October 1988 and December 2021, were analysed. Freedom from events were estimated using the Kaplan-Meier method. Potential differences were analysed using the log rank test and Cox proportional hazard models. Mean ± standard deviation: Bypass time (per minutes) was higher in the group 1 as compared with group 2 (P = 0.050). Survival was not significantly different (P = 0.604) in either groups. Eighteen patients required permanent pacemaker implantation in the group 1 and only one patient required it in the group 2 (P = 0.001).
Conclusions: Paediatric heart transplantation using bicaval technique results similar long-term survival compared with the biatrial technique. The incidence of atrial rhythm disorders was significantly higher in the biatrial group, requiring a higher frequency of pacemaker implantation in this group. As a results, the bicaval technique has replaced the biatrial technique in our centre.
(© 2024 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)
Databáze: MEDLINE
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