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An angiographic study of coronary arterial disease in children after heart transplantation
Published online by Cambridge University Press: 19 August 2008
Summary
Coronary angiograms were analyzed in 29 children after heart transplantation. Age at transplantation was one month to 14 years (mean 4.5 years) with follow-up from five months to six years (mean 2.9 years). Immunosuppression was based on cyclosporine and azathioprine; six patients also received maintenance steroids. Coronary angiograms were obtained after giving an intracoronary arterial bolus of nitroglycerin to avoid spasm. Coronary angiograms showed stenoses, luminal irregularities, loss of luminal diameter and obliteration of branches, and one example of myocardial bridging. The review of angiographic recordings in some patients showed a loss of normal motion of coronary arteries which, instead, appeared rigid. No abnormalities were seen in eight patients (28%). Coronary arterial changes were present between six months and four years after transplantation in 15 patients (52%). Isolated loss of normal motion of the coronary arteries was present in six patients (20%). The separate analysis of 15 patients who underwent more than one coronary angiogram showed a progression of lesions in eight cases. Coronary arterial disease is a frequent complication of heart transplantation in children and there is a progression of lesions in a large proportion of patients. Since there is no satisfactory therapy for this complication, heart transplantation should be reserved for children having no other reasonable therapeutic option.
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- World Forum for Pediatric Cardiology Young Investigator Finalists
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- Copyright © Cambridge University Press 1994
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