PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY AND RETRANSPLANTATION DUE TO TRANSPLANT CORONARY-ARTERY DISEASE

Allograft vascular disease is a significant cause of death of cardiac transplant recipients after the first year of transplantation. With fe w exceptions, angina pectoris does not develop and objective examinati ons, including coronary angiography, are necessary to diagnose coronar y arteriopathy. Between 1983 and 1994, 214 heart transplantations in 2 11 patients were performed in our unit. All survivors had coronary ang iography performed yearly. Thirty patients had significant localized a rterial stenoses. Twelve patients with critical stenosis were accepted for percutaneous transluminal coronary angioplasty. Five patients und erwent retransplantation due to progressive graft vascular disease wit h development of congestive heart failure. Conventional revascularizat ion with transluminal coronary angioplasty can safely be performed wit h primary good results. In selected patients, retransplantation is an option if patients otherwise fulfil standard criteria for cardiac tran splantation.