CORONARY ANGIOPLASTY IN THE TREATMENT OF POST-CARDIAC TRANSPLANT CORONARY-ARTERY DISEASE

Accelerated coronary disease following cardiac transplantation is an i mportant obstacle to long-term survival and its management is not well defined. Coronary angioplasty has been proposed as a palliative treat ment in some patients with discrete proximal lesions. Of 172 patients who underwent cardiac transplantation between April 1983 and November 1995, 8 underwent subsequent coronary angioplasty of 11 lesions. The m ajority was performed in asymptomatic patients, 5 for angiographic abn ormalities alone, and 3 for documented painless ischemia. Primary angi ographic success was obtained in 91% (10/11) of lesions dilated. Compl ications included 1 acute occlusion and 1 arteriovenous fistula. Three patients died, 1, 8 and 10 months after angioplasty. After an average of 36-month follow-up, 4 (out of 8) patients had no cardiac event (my ocardial infarction, second angioplasty, retransplantation or death). Thus, coronary angioplasty can be performed with acceptable risk in se lected patients with. cardiac transplantation.