Successful abdominal aortic aneurysm resection in long-term survivors of cardiac transplantation
J O Defraigne1, N Sakalihasan, J C Demoulin
1Department of Cardiovascular Surgery, Centre Hospitalier Universitaire de Liège, Sart-Tilman University Hospital, Belgium.
Insights
Cardiac transplant recipients face higher risks of extracardiac disease, including abdominal aortic aneurysms. Successful surgical repair is possible, but vigilant screening is crucial for early detection and management in these patients.
Area of Science:
- Cardiovascular Surgery
- Transplantation Medicine
- Vascular Surgery
Background:
- Improved survival in cardiac transplant recipients increases the likelihood of developing extracardiac conditions.
- Abdominal aortic aneurysms (AAAs) are a potential complication in the long-term management of cardiac allograft recipients.
- Risk factors such as post-transplant hypertension and hyperlipidemia may contribute to aneurysm development.
Observation:
- Three cases of cardiac allograft recipients successfully undergoing surgical repair for abdominal aortic aneurysms are presented.
- These procedures were performed 1 to 4 years after the initial cardiac transplantation.
- Pre-operative assessment included evaluation of cardiac function and graft atherosclerosis via coronary angiography.
Findings:
- Abdominal aortic aneurysm resection was successfully performed in all three cardiac transplant patients.
- Patients were discharged in stable condition following the surgical intervention.
- The study highlights the feasibility of AAA repair in this specific patient population.
Implications:
- Abdominal aortic aneurysm resection appears to be a safe procedure for cardiac transplant recipients.
- The rapid growth observed in aneurysms within this cohort necessitates careful and regular screening during follow-up.
- Proactive surveillance strategies are essential for managing vascular complications post-cardiac transplantation.
Abstract:
With the improvement of survival rates following cardiac transplantation, the probability of recipients developing extracardiac disease is increased. Three cases are reported of abdominal aortic aneurysm successfully operated on in cardiac allograft recipients 1 to 4 years after transplantation. Indications for transplantation were valvular, idiopathic and ischaemic cardiomyopathy. Post-transplant hypertension and hyperlipidaemia may have played a role in the rapid growth of the aneurysms. Cardiac function and the incidence of graft atherosclerosis were assessed before surgery by coronary angiography. All three patients were discharged from hospital. Abdominal aortic aneurysm resection may be a safe procedure in cardiac transplant patients. In view of the rapid increase in the size of the aneurysms in transplanted patients, careful screening should be performed during follow-up.
