Angiographic and clinical follow-up of percutaneous revascularization for transplant coronary artery disease.
BACKGROUND
There are limited data on the use of percutaneous revascularization techniques for transplant coronary artery disease (CAD).


METHODS
Medical records and angiographic results for cardiac transplant patients undergoing percutaneous revascularization at Emory University Hospital were reviewed. Procedural results, results of angiography 4Eth 6 months after intervention, and clinical follow-up were recorded.


RESULTS
Nineteen patients underwent 51 interventions. Thirty-eight lesions (75%) were de novo and 13 (25%) were restenotic. All patients had hypertension, 37% had diabetes, 79% had elevated lipid levels, and 53% had at least one episode of moderate to severe allograft rejection (grade 3A or greater). The primary procedural success rate was 100% with no major complications. Six-month restenosis rate (defined as > 50%) was 49%. At 23+/-17 months follow-up, 6 patients were dead or retransplanted (31%). Thirteen patients were alive without retransplantation (9 New York Heart Association class I, 3 class II, 1 class III).


CONCLUSIONS
Percutaneous revascularization is safe and has a high initial procedural success rate in patients with transplant CAD. However, the restenosis rate in this population remains higher than reported for atherosclerotic coronary disease and the long-term prognosis remains poor.
Dempsey
S J
SJ
Center for Heart Failure Therapy, Emory University Hospital, 1364 Clifton Road, N.E., Suite F508, Atlanta, GA, 30322, USA. wendy_book@Emory.org
D'Amico
C
C
Weintraub
W S
WS
Lutz
J
J
Smith
A L
AL
Ghazzal
Z M
ZM
Book
W M
WM
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D016896:Treatment Outcome