title: Thromboaspiration during acute myocardial infarction in a heart transplant patient.
abstract: Each year, an estimated 10% of heart transplant recipients develop coronary allograft vasculopathy, an aggressive form of coronary artery disease that limits survival after transplantation. The pathologic characteristics of coronary allograft vasculopathy are not uniform and both the clinical importance and pathophysiological significance of thrombosis and vasospasm in this setting are not completely understood. Mechanical reperfusion is a better alternative to systemic thrombolysis in patients with acute myocardial infarction and thrombus removal before standard percutaneous coronary intervention improves coronary epicardial flow. We report the case of a 38-year-old male admitted to the emergency room of our hospital with acute inferior myocardial infarction complicated by cardiogenic shock. He underwent heart transplant because of ischemic cardiomyopathy. Coronary angiography showed acute coronary thrombosis of the circumflex coronary artery. Percutaneous coronary intervention with thrombus extraction was successfully attempted. This case represents an unusual clinical presentation and treatment of cardiac allograft vasculopathy.
authors.affiliation: A. De Gasperis Cardiology and Cardiac Surgery Department, Niguarda Ca'Granda Hospital, Milan, Italy. paolacolombo@fastwebnet.it
authors.forename: Paola
authors.initials: P
authors.lastname: Colombo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Bruschi
authors.forename: Manuela
authors.initials: M
authors.lastname: Agozzino
authors.forename: Pedro
authors.initials: P
authors.lastname: Silva
authors.forename: Maria
authors.initials: M
authors.lastname: Frigerio
authors.forename: Ettore
authors.initials: E
authors.lastname: Vitali
authors.forename: Eloisa
authors.initials: E
authors.lastname: Arbustini
authors.forename: Silvio
authors.initials: S
authors.lastname: Klugmann
mesh_terms: D000328:Adult; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D017131:Thrombectomy / Q000379:methods*