Abdominal aortic aneurysms after heart transplantation.
BACKGROUND
In recent years abdominal aortic aneurysms were diagnosed in several heart transplant recipients at our center. Only case reports or small series have been reported previously and little is known about abdominal aortic aneurysms after heart transplantation. Therefore, the goals of this study were to estimate the incidence of this condition after heart transplantation, to identify risk factors for its development, and to assess its clinical consequences.


METHODS
Our investigation was a retrospective, single-center cohort study of 368 consecutive patients transplanted between 1984 and 1999.


RESULTS
During a mean follow-up of 75 +/- 49 months, 37 of the 368 (10%) transplant recipients and 36 of 202 (18%) of the sub-group with a history of ischemic heart disease were found to have an abdominal aortic aneurysm. All patients were male, and all except 1 had a history of ischemic heart disease. A history of ischemic heart disease prior to heart transplantation was the sole independent risk factor for developing an aneurysm by multivariate analysis. Aneurysm-related events occurred earlier and more frequently in the 7 transplant recipients who already had a dilated abdominal aorta prior to transplantation. The abdominal aortic aneurysm was the direct or indirect cause of death in at least 9 patients.


CONCLUSIONS
Abdominal aortic aneurysms are relatively frequent after heart transplantation, occur at a younger age than in the general population, and have serious clinical consequences. Close ultrasonographic follow-up of patients with a history of ischemic heart disease or with an abnormal abdominal aorta prior to heart transplantation seems indicated.
Vantrimpont
Pascal J M J
PJ
Heart Transplantation Unit, Thoraxcentre, Erasmus Medical Centre, Rotterdam, The Netherlands. p.vantrimpont@erasmusmc.nl
van Dalen
Bastiaan M
BM
van Riemsdijk-van Overbeeke
Iza C
IC
Maat
Alex P W M
AP
Balk
Aggie H M M
AH
D017544:Aortic Aneurysm, Abdominal / Q000453:epidemiology* / Q000601:surgery; D015331:Cohort Studies; D005500:Follow-Up Studies; D016027:Heart Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology* / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
D007166:Immunosuppressive Agents