Adult patients with congenital heart disease (ACHD) requiring heart transplantation (HT) usually show complex anatomies, posing surgical challenges. Consequently, we analyzed technical aspects and early and long-term outcomes of additional surgical repairs during HT in ACHD. Forty patients were identified (23 males, median age: 38 years, interquartile range [IQR]: 26–50). Of these, 17 (42.5%) required additional surgical repair (7 systemic veins repair, 13 pulmonary arteries repair). These procedures were more associated with univentricular physiology ( p &lt; 0.001) and prior Fontan palliation ( p &lt; 0.001). Eight (20.0%) experienced 30 day mortality. At a median follow-up of 5.6 (IQR: 2.0–11.9) years, 5 (12.5%) patients died. Additional surgical repair did not affect postoperative 30 day and long-term follow-up mortality ( p = 0.451 and p = 0.330, respectively).

Anatomical Aspects and Long-Term Outcomes of Additional Surgical Repair During Heart Transplantation in Adult Congenital Heart Disease