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%).