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The Journal of Thoracic and Cardiovascular Surgery, Vol 99, 484-491, Copyright © 1990 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
JE Mayer Jr, S Perry, P O'Brien, A Perez-Atayde, RA Jonas, AR Castaneda and IA Parness
Orthotopic heart transplantation has become standard therapy for end- stage
cardiomyopathy in children and adults, but there has been much less
experience with transplantation for complex congenital heart disease. In
this report experience with orthotopic transplantation in seven children
with various forms of complex congenital heart disease is reviewed.
Diagnoses included hypoplastic left heart syndrome in two (after stage I
palliation), left ventricular diverticulum in one, single ventricle in two
(dextrocardia, atrial situs inversus, and total anomalous pulmonary venous
return in one patient and post-Fontan repair in the second),
D-transposition of the great arteries and ventricular septal defect
(post-Senning repair and ventricular septal defect closure) in one, and
Ebstein's anomaly with biventricular dysplasia in one. Six of the seven
were hospital survivors and there has been one late death at 2 1/3 years.
Modifications of the standard operative technique to fit the anatomic
variations in these defects are reviewed.
ARTICLES
Orthotopic heart transplantation for complex congenital heart disease
Department of Cardiovascular Surgery, Children's Hospital, Harvard Medical School, Boston, Mass.
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