Related Experiment Videos
[Percutaneous transluminal coronary angioplasty after orthotopic heart transplantation]
E A Bocchi1, F Vilas-Boas, A A Pedrosa
1Instituto do Coração do Hospital das Clínicas, FMUSP.
Insights
Coronary artery disease developed after heart transplant was successfully treated with percutaneous coronary intervention (PCI). This cardiac intervention improved heart function and patient symptoms, demonstrating its effectiveness in post-transplant patients.
Area of Science:
- Cardiology
- Transplant Medicine
- Interventional Cardiology
Background:
- Coronary artery disease (CAD) is a significant complication following orthotopic cardiac transplantation.
- Post-transplant cardiac dysfunction can manifest as congestive heart failure.
- Graft vasculopathy remains a leading cause of late cardiac allograft loss.
Abstract:
We report the case of 22 year-old male who developed coronary artery disease two years after orthotopic cardiac transplantation, manifested as congestive heart failure NYHA functional class III. The left ventricular radioisotopic evaluation at rest revealed worsening of left ventricular ejection fraction from 50% to 39% (normal value > or = 55%) and septal hypokinesia. The hemodynamic and coronariographic study showed two subocclusive lesions at the mid portion and distal portion of the left descending coronary artery and the patient underwent PTCA of both lesions, successfully reducing them to 30%. A new radionuclide and echocardiographic evaluation of left ventricular function at rest, showed marked improvement of global function no regional abnormalities, increasing the ejection fraction from 39% to 45%. The patient showed improvement of NYHA functional class, passing to functional class II and was discharged home. We conclude that PTCA could be performed in a successful manner in this patient.