Coronary Angioplasty in the Treatment of Post-Cardiac Transplant Coronary Artery Disease.
Accelerated coronary disease following cardiac transplantation is an important obstacle to long-term survival and its management is not well defined. Coronary angioplasty has been proposed as a palliative treatment in some patients with discrete proximal lesions. Of 172 patients who underwent cardiac transplantation between April 1983 and November 1995, 8 underwent subsequent coronary angioplasty of 11 lesions. The majority was performed in asymptomatic patients, 5 for angiographic abnormalities alone, and 3 for documented painless ischemia. Primary angiographic success was obtained in 91% (10/11) of lesions dilated. Complications included 1 acute occlusion and 1 arteriovenous fistula. Three patients died, 1, 8 and 10 months after angioplasty. After an average of 36-month follow-up, 4 (out of 8) patients had no cardiac event (myocardial infarction, second angioplasty, retransplantation or death). Thus, coronary angioplasty can be performed with acceptable risk in selected patients with cardiac transplantation.
Pande
AK
Montreal Heart Institute, 5000 Belanger Street, Montreal, Quebec, H1T 1C8, Canada.
Gosselin
G
Rashdan
I
Carrier
M
Leung
TK
Bonan
R