Severe left main stem stenosis in a cardiac transplant recipient: successful treatment by coronary stenting
1Cardiothoracic Division, South Cleveland Hospital, Middlesbrough, United Kingdom.
Insights
Cardiac transplant recipients can develop severe left main coronary artery stenosis. Percutaneous coronary intervention with stenting offers a successful treatment option for asymptomatic patients, maintaining good results long-term.
Area of Science:
- Cardiology
- Transplant Surgery
- Interventional Cardiology
Background:
- Orthotopic cardiac transplantation is a treatment for end-stage heart failure.
- Coronary artery disease can affect heart transplant recipients.
- Routine surveillance is essential for early detection of complications.
Observation:
- A 58-year-old male, 2 years post-cardiac transplant for ischemic cardiomyopathy, was asymptomatic.
- Coronary angiography revealed severe concentric left main coronary artery stenosis.
- This finding was unexpected in an asymptomatic patient.
Findings:
- Revascularization was recommended for prognostic reasons.
- Percutaneous coronary intervention (PCI) with elective stenting was performed.
- The procedure was successful, with a single stent achieving a good angiographic result.
Implications:
- PCI with stenting is a viable treatment for left main stenosis in cardiac transplant recipients.
- Long-term angiographic success was observed at 6 and 18 months post-procedure.
- This case highlights the importance of vigilant monitoring for coronary artery disease after transplantation.
Abstract:
A 58-year-old male underwent orthotopic cardiac transplantation for ischemic cardiomyopathy. At routine coronary angiography 2 years later, he was found to have severe concentric stenosis of the left main coronary artery but was asymptomatic. Revascularization was recommended on prognostic grounds and after discussion with his cardiac transplant surgeon, percutaneous coronary intervention with elective stenting was offered. This was performed successfully with a single stent and a good angiographic result was maintained 6 and 18 months later.
