Heart transplantation to a physiologic single lung in patients with congenital heart disease

Jacqueline M. Lamour, Daphne T. Hsu, Jan M. Quaegebeur, Sean P. Pinney, Seema R. Mital, Ralph S. Mosca, Jonathan M. Chen, Linda J. Addonizio

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


Heart-lung transplantation has been recommended for patients with end-stage congenital heart disease (CHD) and single-lung physiology due to either discontinuous pulmonary arteries (PAs) and unilateral PA hypertension (HTN) or absence of 1 PA. Eleven patients with CHD and single-lung physiology underwent heart transplantation (HT). Diagnoses included: tetralogy of Fallot, absent left PA (n = 4); single-ventricle s/p classic Glenn (n = 7), with absent left PA (n = 1); and severe left PA HTN (n = 6). Mean time from last surgery was 13 ± 8 years; mean number of operations (op) was 3.2 ± 1.7. Mean age was 21 ± 11 years (range 9.5 to 43). Complications and procedures before HT included hemoptysis (n = 2), plastic bronchitis (n = 1) and interventional catheterization (n = 6). Mean cardiopulmonary bypass and ischemic time was 275 ± 72 and 268 ± 75 minutes, respectively. Mean time to extubation was 4.6 ± 3.2 days, and mean length of stay was 19 ± 7 days. Post-operative morbidity included bleeding (n = 4), vocal cord paralysis (n = 1) and coil embolization of aortopulmonary collaterals (n = 3). Early post-operative survival was 82%. Cause of death was aortic rupture (n = 1) and bleeding (n = 1). Eight patients are alive 4 years (range 0.9 to 7.6) after HT. PA continuity was established in 6 patients; post-HT lung perfusion scan showed no increase in perfusion to the left PA. One patient died from rejection 3 years post-HT. HT can be performed successfully in patients with single-lung physiology. HT is the procedure of choice in patients with end-stage CHD and a physiologic single lung.

Original languageEnglish (US)
Pages (from-to)948-953
Number of pages6
JournalJournal of Heart and Lung Transplantation
Issue number8
StatePublished - Aug 1 2004
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine
  • Transplantation


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