Surgical Indications, Clinical Profile, and Comorbidities
The main indications for HTx included idiopathic dilated cardiomyopathy
(DCM) in 55 (66.3%) patients and ischaemic cardiomyopathy in 15
(18.1%) patients. The other indications are also shown in Table 1.
The general preoperative left ventricular ejection fraction (LVEF) was
22.9 ± 14.5% (6 - 70%). In male, the LVEF was 19.9 ± 10.6% (6 -
67%), compared with 29.3 ± 19.3% (10 - 70%) in female. As for adults,
the LVEF was 22.4 ± 14.6% (6 - 70%), compared with 26.2 ± 13.6% (10 -
57%) in pediatric patients. Overall, 74 (89.2%) patients had a reduced
LVEF (<40%). There was a significant difference between sexes
(p = 0.04) but not between age groups (p = 0.19) regarding the
preoperative LVEF.
According to their clinical profile and condition, 61 recipients
(73.5%) were clinically categorized as Interagency Registry for
Mechanically Assisted Circulatory Support (INTERMACS) Profile 3 before
transplantation (11). Thus, 45 (54.2%) were on intravenous inotropic
support, of which 12 (14.5%) required mechanical assist device support:
5 of them with intra-aortic balloon pump (IABP), 4 had an implanted left
ventricular assist device (VAD), and 3 had an implanted bi-VAD (Thoratec
Corporation, CA, USA).
Among comorbidities, the most frequent were pulmonary hypertension
(25.3%), hypothyroidism (19.3%), chronic kidney disease (15.7%),
arterial hypertension (14.5%), and diabetes mellitus (8.4%).