title: Heart transplant patient outcomes: 5-year mean follow-up by coronary computed tomography angiography.
abstract: BACKGROUND
  We evaluate the feasibility and safety of coronary computed tomography angiography (CCTA) as the first-line investigation in heart transplant patients and the rate of coronary allograft vasculopathy detected using CCTA.
  
  
  METHODS
  From September 2003 to June 2009, we prospectively included 65 heart transplant recipients, retaining 62 who underwent yearly CCTA for coronary allograft vasculopathy detection (261 CCTAs). We used 16-slice, 64-slice, and 2×64-slice CT machines. Patients with coronary artery stenosis by CCTA had a confirmation and a further follow-up exclusively by conventional coronary angiography (CCA).
  
  
  RESULTS
  No major coronary events occurred during the study. Of the 62 baseline CCTAs, 37 (60%) were normal, 18 (29%) showed wall thickening, and 7 (11%) known significant stenosis, confirmed by CCA. The mean follow-up duration was 5 years. At the last follow-up, 26 (70%) patients with normal baseline findings remained normal, 9 (24%) had wall thickening, and 2 (6%) significant stenoses. Time to stenosis was consistently greater than 3 years. Of the 18 patients with initially wall thickening, 14 (78%) had wall thickening and 4 (22%) significant stenosis at last follow-up. The mean interval without any coronary lesion was 9.46±3.98 years. The mean interval without de novo significant stenosis was 10.31±4 years.
  
  
  CONCLUSIONS
  CCTA seems to be a safe noninvasive tool for monitoring heart transplant patients, and thus obviating the need for CCA. In patients with normal baseline CCTA, a 2-year interval between CCTAs may be safe.
authors.affiliation: Department of Radiology, Cardio-Thoracic Surgical Center Marie Lannelongue, 133 Avenue de la Resistance, 92 350 LePlessis Robinson, France. adelarohnean@yahoo.com
authors.forename: Adela
authors.initials: A
authors.lastname: Rohnean
authors.forename: Lucile
authors.initials: L
authors.lastname: Houyel
authors.forename: Anne
authors.initials: A
authors.lastname: Sigal-Cinqualbre
authors.forename: Ngoc-Tram
authors.initials: NT
authors.lastname: To
authors.forename: Eric
authors.initials: E
authors.lastname: Elfassy
authors.forename: Jean-Francois
authors.initials: JF
authors.lastname: Paul
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000792:Angiography / Q000009:adverse effects / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000601:surgery*; D016027:Heart Transplantation; D006801:Humans; D015994:Incidence; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D036542:Tomography, Spiral Computed / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult