Related Experiment Video
Updated: Jul 11, 2026
Implantation of the Syncardia Total Artificial Heart
Published on: July 18, 2014
Cardiac CT of the transplanted heart: indications, technique, appearance, and complications
Naama R Bogot1, Ronen Durst, Dorith Shaham
1Department of Radiology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. naamab@hadassah.org.il
Insights
Coronary allograft vasculopathy is a major risk for heart transplant recipients. Cardiac CT offers a noninvasive method for its early detection and management, improving long-term outcomes.
Area of Science:
- Cardiology
- Transplant Medicine
- Medical Imaging
Background:
- Long-term survival after heart transplantation is limited by coronary allograft vasculopathy.
- Current screening via coronary angiography is invasive and detects disease indirectly.
- Coronary angiography has a 1%-2% risk of complications.
Purpose of the Study:
- To evaluate the utility of electrocardiographically gated multidetector computed tomography (CT) for assessing coronary allograft vasculopathy.
- To explore cardiac CT's potential for comprehensive, noninvasive evaluation of transplanted hearts.
Main Methods:
- Utilized electrocardiographically gated multidetector computed tomography (CT).
- Assessed coronary artery lumen and wall for signs of vasculopathy.
- Explored CT's capability for detecting other post-transplant complications.
Main Results:
- Cardiac CT provides a comprehensive, noninvasive evaluation of the transplanted heart.
- CT enables assessment of coronary artery lumen and wall, aiding in vasculopathy detection.
- CT can identify other complications like malignancy, infection, and assess anastomoses and function.
Conclusions:
- Cardiac CT is a valuable tool for screening, diagnosis, grading, and follow-up of coronary allograft vasculopathy.
- This noninvasive imaging modality offers a superior alternative to angiography for transplanted heart evaluation.
- Cardiac CT may improve management of heart transplant recipients by enabling early detection of complications.
Abstract:
Effective antirejection therapy and infection control have significantly improved the long-term survival of heart transplant recipients, but coronary allograft vasculopathy remains an important limiting factor. Most heart transplant recipients undergo annual coronary angiography for the detection of allograft vasculopathy, which is often clinically silent. Angiography allows detection of vasculopathy only indirectly, with depiction of the lumen, and does not depict the wall thickening and intimal hyperplasia that typify this disease; the procedure also is invasive and is associated with a 1%-2% risk of complication. In contrast, electrocardiographically gated multidetector computed tomography (CT) can provide a comprehensive and noninvasive evaluation of the transplanted heart in a single study. Cardiac CT enables evaluation of the coronary artery lumen and wall and thus may be used for screening, diagnosis, grading, and follow-up of coronary allograft vasculopathy. It also may be used to detect other posttransplantation complications, such as malignancy and infection, and to assess cardiac and vascular anastomoses and cardiac function. However, special strategies may be needed to reduce the transplant heart rate so as to obtain images of diagnostic quality.
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