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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

Ana Ladeia ,
Jérôme Le Bidois ,
Jean François Piéchaud ,
Jean Philippe Metzger ,
Pascal Vouhé  and
Jean Kachaner
Ana Ladeia
Affiliation:
From the Service de Cardiologie Pédiatrique, Hopital Laënnec, Paris
Jérôme Le Bidois*
Affiliation:
From the Service de Cardiologie Pédiatrique, Hopital Laënnec, Paris
Jean François Piéchaud
Affiliation:
From the Service de Cardiologie Pédiatrique, Hopital Laënnec, Paris
Jean Philippe Metzger
Affiliation:
Service de Cardiologie, Hopital Laënnec, Paris
Pascal Vouhé
Affiliation:
Hopital Necker Enfants Malades and the Service de Chirurgie Cardiovasculaire, Hopital Laënnec, Paris
Jean Kachaner
Affiliation:
From the Service de Cardiologie Pédiatrique, Hopital Laënnec, Paris
*
Dr. Jérôme Le Bidois, Service de Cardiologie Pédiatrique, Hopital Necker Enfants Malades, 149, rue de Sèvres, 75015 Paris, France. Tel. (33-1) 44 49 43 42; Fax. (33-1) 44 49 43 40.
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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.

Keywords

Heart transplantationchildrencoronary arterial diseasecoronary angiography
Type
World Forum for Pediatric Cardiology Young Investigator Finalists
Information
Cardiology in the Young , Volume 4 , Issue 1 , January 1994 , pp. 15 - 18
Copyright
Copyright © Cambridge University Press 1994

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References

Scott, CD, Dark, JH. Coronary artery disease after heart transplantation: clinical aspects. Br Heart J 1992; 68: 255–256.Google Scholar
Pahl, E, Fricker, FJ, Armitage, J, Griffith, BP, Taylor, S, Uretsky, BF, Beerman, LB, Zuberbuhler, JR. Coronary arteriosclerosis in pediatric heart transplant survivors: limitation of long-term survival. J Pediatr 1990; 116: 177–183.CrossRefGoogle ScholarPubMed
Addonizio, LJ, Hsu, DT, Smith, CR, Gersony, WM, Rose, EA.Late complications in pediatric cardiac transplant recipients. Circulation 1990; 82(Suppl IVyes): 1V 295–IV 301.Google Scholar
Braunlin, EA, Hunter, DW, Canter, CE, Gutierrez, FR, Ring, WS, Olivari, MT, Titus, JL, Spray, TL, Bolman, RM IIICoronary artery disease in pediatric cardiac transplant recipients receiving triple-drug immunosuppression. Circulation 1991; 84(Suppl IIIyes-): III 303–III 309.Google ScholarPubMed
Hosenpud, JD, Shipley, GD, Wagner, CR. Cardiac allograft vasculopathy: current concepts, recent developments, and future directions. J Heart Lung Transplant 1992; 11: 9–23.Google Scholar
Billingham, ME. Cardiac transplant atherosclerosis. Transplant Proc 1987; 19: 19–25.Google Scholar
Uretsky, BF, Kormos, RL, Zerbe, TR, Lee, A, Tokarczyk, TR, Murali, S, Reddy, PS, Denys, BG, Griffith, BP, Hardesty, RL, Armitage, JM, Arena, VC.. Cardiac events after heart transplantation: incidence and predictive value of coronary arteriography. J Heart Lung Transplant 1992; 11: 545–551.Google Scholar
Mullins, PA, Cary, NR, Sharples, L, Scott, J, Aravot, D, Large, SR, Wallwork, J, Schofield, PM.. Coronary occlusive disease and late graft failure after cardiac transplantation. Br Heart J 1992;68: 260–265.CrossRefGoogle ScholarPubMed
Kaye, MP. The registry of the International Society for Heart and Lung Transplantation: ninth official report-1992. J Heart Lung Transplant 1992; 11: 599–606.Google Scholar