ACUTE MYOCARDIAL-INFARCTION IMMEDIATELY AFTER HEART-TRANSPLANTATION

Myocardial infarction is one of the rarer events causing acute graft f ailure during the postoperative period after transplantation and is us ually caused by preexisting coronary artery disease of the donor heart . We discuss the case of a 56-year-old man in whom cardiogenic shock d eveloped after heart transplantation, which was refractory to all medi cal treatment. He was put on emergency code and underwent retransplant ation 30 hours later. Pathologic examination of the explanted donor he art showed massive recent inferior and posterior wall infarction, with normal coronary arteries; the right coronary artery was dominant and completely occluded by an embolus of fatty material surrounded by fibr in, which we suggest could have originated from the suture line of the left atrium.