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Combined coronary intervention in heart-transplant patient with rapidly accelerated cardiac allograft vasculopathy

Authors
  • Koyanagi, Toshiya1
  • Kyo, Shunei1
  • Ouchi, Hiroshi1
  • Asano, Haruhiko1
  • Yokote, Yuji1
  • Omoto, Ryozo1
  • 1 Saitama Medical School, Department of Surgery, Saitama, Japan , Saitama (Japan)
Type
Published Article
Journal
The Japanese Journal of Thoracic and Cardiovascular Surgery
Publisher
Springer-Verlag
Publication Date
May 14, 2014
Volume
49
Issue
2
Identifiers
DOI: 10.1007/BF02912128
Source
Springer Nature
Keywords
License
Yellow

Abstract

A 46-year-old man accepted for heart transplantation due to persistent cardiac failure from dilated cardiomyopathy underwent a transplant in Germany on July 13, 1995. The donor heart was suspected of coronary artery disease at explantation, but he could wait no longer because of his rapidly deteriorating hemodynamics. Postoperative coronary angiography revealed 25% stenosis of the left descending artery. He showed several episodes of minimal or moderate rejection postoperatively, and coronary angiography 15 months postoperatively showed rapidly accelerated cardiac allograft vasculopathy demonstrating triple vessel disease with multiple lesions. Percutaneous transluminal coronary angioplasty was successful on 2 coronary vessels, but immediately recurrent stenosis and new lesions involving the left main trunk occurred 6 weeks thereafter. Since he was financially unable to afford a second heart transplantation, quadruple coronary artery bypass grafting was conducted October 25, 1996. A biventricular assist device was used when he could not be weaned from cardiopulmonary bypass. He died of multiple organ failure 3 days after surgery.

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