Thrombus causing fatal left ventricular outflow tract obstruction in a heart transplant patient.
A 60 year male, orthotopic heart transplant recipient developed a fatal left ventricular outflow obstruction secondary to thrombus at 38 months post transplant. Although he had episodes of mild to moderate rejection at 2 and 16 months post transplant, subsequent biopsies were negative and annual cardiac catheterizations showed mild left ventricular hypokinesis and normal coronary arteries. This case represents a catastrophic complication of transplant rejection and illustrates the problems with identifying rejection using current diagnostic methods.
Clark
V L
VL
Heart Failure and Cardiac Transplant, Henry Ford Hospital, Michigan 48202.
Levine
T B
TB
D017023:Coronary Angiography; D006084:Graft Rejection / Q000502:physiology; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000473:pathology; D016027:Heart Transplantation / Q000473:pathology / Q000502:physiology*; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000473:pathology; D013927:Thrombosis / Q000000981:diagnostic imaging*; D014694:Ventricular Outflow Obstruction / Q000000981:diagnostic imaging*