Combined heart–liver transplantation for failing Fontan circulation in a late survivor with single‐ventricle physiology
نویسندگان
چکیده
Management of adults with failing Fontan physiology poses many challenges, especially as transplantation offers the only realistic alternative to palliative care. We present the first combined heart and liver transplant performed in Europe, for a late survivor of single ventricle palliation with the Fontan circulation. In addition to the conventional medical and surgical challenges posed, we highlight the management of the associated multi-organ failure with focus on the liver and novel strategies for assessment and optimization.
منابع مشابه
Orthotopic Heart Transplantation in Patients with Univentricular Physiology
Parallel advancements in surgical technique, preoperative and postoperative care, as well as a better understanding of physiology in patients with duct-dependent pulmonary or systemic circulation and a functional single ventricle, have led to superb results in staged palliation of most complex congenital heart disease (CHD) [1]. The Fontan procedure and its technical modifications have resulted...
متن کاملHeart transplantation in single-ventricle physiology with failed fontan circulation
Methods Between 1986 and 2011, 179 children underwent heart transplantation for cardiomyopathy and end-stage congenital heart disease. Fifteen patients had single-ventricle physiology and underwent Fontan procedure. Five patients (mean age 6.6±1.2, range 2-14, years old) had failed Fontan circulation. Interval between Fontan procedure and failing circulation was 8-14 years. Indications for hear...
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OBJECTIVE Evaluation of incremental risk factors for early mortality in children undergoing orthotopic heart transplantation (OHT) for congenital heart disease. METHODS Between 1988 and 2002, 43 patients (mean age 9.1+/-7.2 years) underwent 44 OHT for complex TGA (6), DORV (4), single ventricle (21), and other end-stage structural heart disease (11). Two discernible ventricular chambers were ...
متن کاملOrthotopic heart transplantation for failing single ventricle physiology.
OBJECTIVE Evaluation of incremental risk factors for early mortality in children undergoing orthotopic heart transplantation (OHT) for failing single ventricle physiology. METHODS Between 1988 and 2002, 25 patients (mean age 9.3+/-7.1 years) underwent OHT for complex congenital heart disease (CHD) with a functional right (15 patients) or left (10 patients) single ventricle. Palliative staging...
متن کاملIn vivo quantification of blood mixing in single ventricle patients with Fontan circulation using 4D flow MRI
Background Single ventricle physiology (SVP) is one of the most severe forms of complex congenital heart disease (CHD). Patients undergo multiple surgical interventions including the Fontan procedure (caval venous return is routed directly to the pulmonary arteries). Despite the apparent success of the procedure, it is unclear why some patients develop ‘failing Fontan physiology’ while others r...
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عنوان ژورنال:
دوره 4 شماره
صفحات -
تاریخ انتشار 2017