A COVERED CORONARY STENT FOR ACUTE PERFORATION AFTER A PERCUTANEOUS CORONARY INTERVENTION DUE TO CARDIAC ALLOGRAFT
Mario Udovičić1,2, Hrvoje Falak1, Miro Raguž1
1Department of Cardiovascular Diseases, University Hospital Dubrava, Zagreb.
Insights
Cardiac allograft vasculopathy (CAV) is a common complication after heart transplantation (HTx). This case report details a successful intervention for coronary perforation during percutaneous coronary intervention for CAV.
Area of Science:
- Cardiology
- Transplantation Immunology
Background:
- Cardiac allograft vasculopathy (CAV) is a significant cause of late graft failure and mortality post-heart transplantation (HTx).
- It is characterized by diffuse concentric narrowing of coronary arteries due to intimal fibriproliferation.
- CAV affects a substantial proportion of heart transplant recipients within 10 years.
Observation:
- A 33-year-old patient with newly diagnosed CAV underwent percutaneous coronary intervention (PCI) for the circumflex coronary artery.
- During the PCI procedure, a coronary perforation occurred.
- The perforation was successfully managed with the deployment of a covered single stent.
Findings:
- The covered stent effectively sealed the coronary perforation.
- This intervention allowed for continued management of CAV in a complex post-transplant setting.
Implications:
- This case highlights the successful use of covered stents to manage coronary perforation during PCI for CAV.
- It suggests a viable treatment option for complications arising during interventional procedures in CAV patients.
- Further research may explore the long-term outcomes of this technique in managing CAV-related complications.
Abstract:
Cardiac allograft vasculopathy (CAV) is diffuse concentric narrowing caused by intimal fibriproliferation of the coronary arteries in patients after heart transplantation (HTx). It affects almost one third of patients over the period of 5 years, and more than 50% after 10 years following HTx and remains a common cause of late graft failure and mortality. Percutaneous coronary intervention (PCI) can be attempted for focal disease preferably with drug-eluting stents, but the only definite solution is re-transplantation reserved for selected patients with severe CAV. We report a case of a 33- year-old patient with a newly diagnosed CAV, in which a PCI of circumflex coronary artery was attempted, resulting in a coronary perforation treated by the placement of a covered single stent.
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