Vol 61, No 10 (2004)
Other
Published online: 2005-12-12
Submitted: 2012-12-28
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Percutaneous coronary interventions in patients with transplanted heart coronary artery disease. Effects of intracoronary stent implantation on long-term results

Michał Zakliczyński, Marcin Świerad, Andrzej Lekston, Marcin Maruszewski, Helena Zakliczyńska, Anna Barańska-Kosakowska, Roman Przybylski, Zbigniew Kalarus, Marian Zembala
Kardiol Pol 2004;61(10):344-348.
Vol 61, No 10 (2004)
Other
Published online: 2005-12-12
Submitted: 2012-12-28

Abstract

Background: Transplanted heart coronary artery disease (TxCAD) is the most frequent casue of death occuring ≥5 years after orthotopic heart transplantation (OHT). Considering three basic therapeutic approaches - percutaneous coronary intervention (PCI), surgical revascularisation and retransplantation - PCI seems to be the superior method due to its safety and good short-term results, however, the long-term efficacy of PCI has been less well established.
Aim: To evaluate long-term results of PCI in the treatment of OHT recipients with TxCAD.
Methods: The study group consisted of 20 patients (19 males, aged 24-63, median 45.5 years; 14 (70%) had before OHT), who underwent single or multiple PCI of significant coronary lesions, revealed by elective (n=17) or urgent (n=3) coronary angiography (CAG). The overall number of PCI procedures was 26, including 8 with stent implantation. procedures were performed 9-151 (median 61.5) months after OHT. Analysis of PCI results was based on the follow-up CAGs or autopsy in case of death.
Results: Follow-up time was 3-90 (median 28) months. At least one CAG was performed in 17 (85%) patients - the overall number of follow-up CAGs was 53. Progression of TxCAD was revealed by 33 (62%) CAGs - the decision to perform subsequent single or multiple PCI was undertaken in 22 (42%) patients. The overall number of re-PCI procedures was 38 (with stent implantation in 11 cases). Out of 38 PCI procedures without stent implantation, significant restenosis was found on control CAG in 16 (42%) patients, and out of 16 PCI with stents - in 11 (69%) patients, including 8 haemodynamically significant lesions. TxCAD was the cause of 5 out of 9 deaths that occurred during follow-up.
Conclusions: PCI is unable to stop TxCAD development in the majority of patients. Stent implantation does not improve long-term results of TxCAD treatment.

Abstract

Background: Transplanted heart coronary artery disease (TxCAD) is the most frequent casue of death occuring ≥5 years after orthotopic heart transplantation (OHT). Considering three basic therapeutic approaches - percutaneous coronary intervention (PCI), surgical revascularisation and retransplantation - PCI seems to be the superior method due to its safety and good short-term results, however, the long-term efficacy of PCI has been less well established.
Aim: To evaluate long-term results of PCI in the treatment of OHT recipients with TxCAD.
Methods: The study group consisted of 20 patients (19 males, aged 24-63, median 45.5 years; 14 (70%) had before OHT), who underwent single or multiple PCI of significant coronary lesions, revealed by elective (n=17) or urgent (n=3) coronary angiography (CAG). The overall number of PCI procedures was 26, including 8 with stent implantation. procedures were performed 9-151 (median 61.5) months after OHT. Analysis of PCI results was based on the follow-up CAGs or autopsy in case of death.
Results: Follow-up time was 3-90 (median 28) months. At least one CAG was performed in 17 (85%) patients - the overall number of follow-up CAGs was 53. Progression of TxCAD was revealed by 33 (62%) CAGs - the decision to perform subsequent single or multiple PCI was undertaken in 22 (42%) patients. The overall number of re-PCI procedures was 38 (with stent implantation in 11 cases). Out of 38 PCI procedures without stent implantation, significant restenosis was found on control CAG in 16 (42%) patients, and out of 16 PCI with stents - in 11 (69%) patients, including 8 haemodynamically significant lesions. TxCAD was the cause of 5 out of 9 deaths that occurred during follow-up.
Conclusions: PCI is unable to stop TxCAD development in the majority of patients. Stent implantation does not improve long-term results of TxCAD treatment.
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Keywords

transplanted heart coronary artery disease - coronary angioplasty - stents - outcome

About this article
Title

Percutaneous coronary interventions in patients with transplanted heart coronary artery disease. Effects of intracoronary stent implantation on long-term results

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 61, No 10 (2004)

Pages

344-348

Published online

2005-12-12

Bibliographic record

Kardiol Pol 2004;61(10):344-348.

Keywords

transplanted heart coronary artery disease - coronary angioplasty - stents - outcome

Authors

Michał Zakliczyński
Marcin Świerad
Andrzej Lekston
Marcin Maruszewski
Helena Zakliczyńska
Anna Barańska-Kosakowska
Roman Przybylski
Zbigniew Kalarus
Marian Zembala

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