A. Lipski et al., ACUTE MYOCARDIAL-INFARCTION IMMEDIATELY AFTER HEART-TRANSPLANTATION, The Journal of heart and lung transplantation, 12(6), 1993, pp. 1065-1066
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.