European Journal of Cardio-Thoracic Surgery, Vol 9, 521-525, Copyright © 1995 by European Association for Cardio-thoracic Surgery
Mid-term results of heart transplantation for end-stage valvular disease
U Livi, AL Caforio, GM Boffa, V Tursi, G Thiene and D Casarotto
Department of Cardiovascular Surgery, University of Padova Medical School, Italy.
The results of heart transplantation in a consecutive series of 19 end-
stage valvular disease patients (15 male, aged 48 +/- 8 years) were
analysed retrospectively. The indication for heart transplantation was
heart failure due to left and/or right ventricular dysfunction; 16 patients
had undergone previous valve surgery, but prosthetic dysfunction was
present in only one patient. All patients were in NYHA class IV, 15 were on
oral anticoagulants and 5 on i.v. catecholamine support. There were four
in-hospital deaths (21%) and one late death (5%), resulting in a 1-year
mortality rate slightly, but not significantly, higher than that of
patients transplanted for other indications (16%). Mean follow-up of the
survivors was 48 +/- 33 months (range 9-95); 5-year actuarial survival was
similar to that observed among the other heart transplantation patients (74
+/- 10% vs 77 +/- 3%, P = NS). The incidence of acute rejection and
infection was also similar in valvular disease and non-valvular disease
patients. Kidney and liver function at 1 year post-heart transplantation
was preserved in all cases; cardiac catheterization revealed normal graft
function in all patients and the absence of coronary lesions in all but
two. In conclusion, in our limited experience morbidity and mortality in
patients transplanted for end-stage valvular disease seem to be similar to
those of patients undergoing heart transplantation for other etiologies.
