Heart transplant coronary artery disease: Multimodality approach in percutaneous intervention
Coronary artery disease is the most important cause of late morbidity and mortality after heart transplantation. It is usually an immunologic phenomenon termed cardiac allograft vasculopathy, but can also be the result of donor-transmitted atherosclerosis. Routine surveillance by coronary angiograph...
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doaj-5869527942934722a731721af46696dd2020-11-25T01:40:13ZengElsevierRevista Portuguesa de Cardiologia (English Edition)2174-20492016-06-01356377.e1377.e5Heart transplant coronary artery disease: Multimodality approach in percutaneous interventionLuís Leite0Vítor Matos1Lino Gonçalves2João Silva Marques3Elisabete Jorge4João Calisto5Manuel Antunes6Mariano Pego7Cardiology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Corresponding author.Cardiology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, PortugalCardiology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, PortugalCardiology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, PortugalCardiology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, PortugalCardiology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, PortugalCardiothoracic Surgery Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, PortugalCardiology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, PortugalCoronary artery disease is the most important cause of late morbidity and mortality after heart transplantation. It is usually an immunologic phenomenon termed cardiac allograft vasculopathy, but can also be the result of donor-transmitted atherosclerosis. Routine surveillance by coronary angiography should be complemented by intracoronary imaging, in order to determine the nature of the coronary lesions, and also by assessment of their functional significance to guide the decision whether to perform percutaneous coronary intervention. We report a case of coronary angiography at five-year follow-up after transplantation, using optical coherence tomography and fractional flow reserve to assess and optimize treatment of coronary disease in this challenging population. Resumo: Doença coronária é a causa mais importante de morbimortalidade tardia após transplantação cardíaca. Habitualmente, representa um fenómeno imunológico designado como vasculopatia do aloenxerto, mas também pode resultar da aterosclerose transmitida pelo dador. A vigilância através de coronariografia de rotina deve ser complementada pela utilização de imagem intracoronária, de forma a determinar a natureza das lesões, e também através de uma avaliação funcional para tomada da decisão de realizar intervenção coronária percutânea. Apresentamos o caso de uma coronariografia aos cinco anos de seguimento após transplantação, utilizando tomografia de coerência ótica e fractional flow reserve para avaliação e otimização do tratamento da doença coronária nesta população desafiante. Keywords: Heart transplantation, Coronary artery disease, Cardiac allograft vasculopathy, Optical coherence tomography, Fractional flow reserve, Percutaneous coronary intervention, Palavras-chave: Transplante cardíaco, Doença coronária, Vasculopatia do enxerto, Tomografia de coerência ótica, Fractional flow reserve, Intervenção coronária percutâneahttp://www.sciencedirect.com/science/article/pii/S217420491630068X |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Luís Leite Vítor Matos Lino Gonçalves João Silva Marques Elisabete Jorge João Calisto Manuel Antunes Mariano Pego |
spellingShingle |
Luís Leite Vítor Matos Lino Gonçalves João Silva Marques Elisabete Jorge João Calisto Manuel Antunes Mariano Pego Heart transplant coronary artery disease: Multimodality approach in percutaneous intervention Revista Portuguesa de Cardiologia (English Edition) |
author_facet |
Luís Leite Vítor Matos Lino Gonçalves João Silva Marques Elisabete Jorge João Calisto Manuel Antunes Mariano Pego |
author_sort |
Luís Leite |
title |
Heart transplant coronary artery disease: Multimodality approach in percutaneous intervention |
title_short |
Heart transplant coronary artery disease: Multimodality approach in percutaneous intervention |
title_full |
Heart transplant coronary artery disease: Multimodality approach in percutaneous intervention |
title_fullStr |
Heart transplant coronary artery disease: Multimodality approach in percutaneous intervention |
title_full_unstemmed |
Heart transplant coronary artery disease: Multimodality approach in percutaneous intervention |
title_sort |
heart transplant coronary artery disease: multimodality approach in percutaneous intervention |
publisher |
Elsevier |
series |
Revista Portuguesa de Cardiologia (English Edition) |
issn |
2174-2049 |
publishDate |
2016-06-01 |
description |
Coronary artery disease is the most important cause of late morbidity and mortality after heart transplantation. It is usually an immunologic phenomenon termed cardiac allograft vasculopathy, but can also be the result of donor-transmitted atherosclerosis. Routine surveillance by coronary angiography should be complemented by intracoronary imaging, in order to determine the nature of the coronary lesions, and also by assessment of their functional significance to guide the decision whether to perform percutaneous coronary intervention. We report a case of coronary angiography at five-year follow-up after transplantation, using optical coherence tomography and fractional flow reserve to assess and optimize treatment of coronary disease in this challenging population. Resumo: Doença coronária é a causa mais importante de morbimortalidade tardia após transplantação cardíaca. Habitualmente, representa um fenómeno imunológico designado como vasculopatia do aloenxerto, mas também pode resultar da aterosclerose transmitida pelo dador. A vigilância através de coronariografia de rotina deve ser complementada pela utilização de imagem intracoronária, de forma a determinar a natureza das lesões, e também através de uma avaliação funcional para tomada da decisão de realizar intervenção coronária percutânea. Apresentamos o caso de uma coronariografia aos cinco anos de seguimento após transplantação, utilizando tomografia de coerência ótica e fractional flow reserve para avaliação e otimização do tratamento da doença coronária nesta população desafiante. Keywords: Heart transplantation, Coronary artery disease, Cardiac allograft vasculopathy, Optical coherence tomography, Fractional flow reserve, Percutaneous coronary intervention, Palavras-chave: Transplante cardíaco, Doença coronária, Vasculopatia do enxerto, Tomografia de coerência ótica, Fractional flow reserve, Intervenção coronária percutânea |
url |
http://www.sciencedirect.com/science/article/pii/S217420491630068X |
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