Intractable coronary fibromuscular dysplasia leading to end‐stage heart failure and fatal heart transplantation

• Main Authors: Magdalena Maria Cattaneo, Marco Moccetti, Mattia Cattaneo, Daniel Sürder, Thomas Suter, Michele Martinelli, Eva Roost, Jürg Schmidli, Yara Banz, Carmen Schneiders, Giovanni Pedrazzini, Roberto Corti, Lorenz Räber, Filippo Crea, Paul Mohacsi, Augusto Gallino
• Format: Article
• Language: English
• Published: Wiley 2020-04-01
• Series: ESC Heart Failure
• Subjects: Coronary fibromuscular dysplasia; Orthotopic heart transplantation; Refractory coronary artery spasm; Coronary artery dissection
• Online Access: https://doi.org/10.1002/ehf2.12626
• ISSN: 2055-5822

Abstract Coronary fibromuscular dysplasia is uncommon, and even rarer its unstable and recurrent course. We present the unique case of a 52‐year‐old woman who underwent in total 12 coronary angiographies and three percutaneous coronary intervention within 24 months because of repetitive acute coronary syndromes due to refractory spasm, dissection, restenosis all leading to end‐stage heart failure, and heart transplantation. The patient died 12 days after the heart transplantation complicated by intraoperative acute thrombotic occlusion of left anterior descending artery of the graft despite normal pretransplant coronary angiography. Autopsy of the recipient heart confirmed coronary fibromuscular dysplasia with massive intimal hyperplasia and restenosis.