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Coronary interventional procedures in pediatric heart transplant recipients with cardiac allograft vasculopathy

2000; Elsevier BV; Volume: 85; Issue: 11 Linguagem: Inglês

10.1016/s0002-9149(00)00773-6

1879-1913

Robert E. Shaddy, J. Revenaugh, Garth S. Orsmond, Lloyd Y. Tani,

Cardiac Structural Anomalies and Repair

Cardiac allograft vasculopathy (CAV) is the main limiting factor to long-term survival after pediatric heart transplantation. 1 Boucek M.M. Novick R.J. Bennett L.E. Fiol B. Keck B.M. Hosenpud J.D. The registry of the International Society of Heart and Lung Transplantation second official pediatric report –1998. J Heart Lung Transplant. 1998; 17: 1141-1160 PubMed Google Scholar Although the exact incidence of CAV after pediatric heart transplantation is unknown, reported incidences have ranged from 3% to 43%. 2 Radley-Smith R.C. Yacoub M.H. Long-term results of pediatric heart transplantation. J Heart Lung Transplant. 1992; 11: S277-S281 PubMed Google Scholar , 3 Braunlin E.A. Hunter D.W. Canter C.E. Gutierrez F.R. Ring W.S. Olivari M.T. Titus J.L. Spray T.L. Bolman R.M. Coronary artery disease in pediatric cardiac transplant recipients receiving triple-drug immunosuppression. Circulation. 1991; 84: III-303-III-309 Google Scholar , 4 Pahl E. Zales V.R. Fricker F.J. Addonizzio L.J. Posttransplant coronary artery disease in children. A multicenter national survey. Circulation. 1994; 90: II-56-II-60 Google Scholar Treatment options have been very limited, but some centers have advocated early listing for retransplantation as soon as the diagnosis of CAV is made because of risks of rapid deterioration and sudden death. 5 Razzouk A.J. Chinnock R.E. Dearani J.A. Gundry S.R. Bailey L.L. Cardiac retransplantation for graft vasculopathy in children should we continue to do it?. Arch Surg. 1998; 133: 881-885 Crossref PubMed Scopus (30) Google Scholar In adult heart transplant recipients, coronary interventions including balloon and laser angioplasty, stenting, atherectomy, and bypass surgery have met with limited success. 6 Halle A.A. DiSciascio G. Massin E.K. Wilson R.F. Johnson M.R. Sullivan H.J. Bourge R.C. Kleiman N.S. Miller L.W. Aversano T.R. Wray R.B. Hunt S.A. Weston M.W. Davies R.A. Rincon G. Crandall C.C. Cowley M.J. Kubo S.H. Fisher S.G. Vetrovec G.W. Coronary angioplasty, atherectomy, and bypass surgery in cardiac transplant recipients. J Am Coll Cardiol. 1995; 26: 120-128 Abstract Full Text PDF PubMed Scopus (186) Google Scholar , 7 Fiane A.E. Klow N.E. Simonsen S. Levorstad K. Geiran O. Percutaneous transluminal angioplasty and retransplantation due to transplant coronary artery disease. Scand Cardiovasc J. 1997; 31: 223-227 Crossref PubMed Scopus (4) Google Scholar , 8 Heublein B. Pethig K. Maab C. Wahlers T. Haverich A. Coronary artery stenting in cardiac allograft vascular disease. Am Heart J. 1997; 134: 930-938 Abstract Full Text PDF PubMed Google Scholar , 9 Wong P.M.T. Piamsomboon C. Mathur A. Chastain H.D. Singh D.J. Liu M.W. Parks J.M. Iyer S. Dean L.S. Baxley W.A. Bourge R.C. Roubin G.S. Efficacy of coronary artery stenting in the management of cardiac allograft vasculopathy. Am J Cardiol. 1998; 82: 239-241 Abstract Full Text Full Text PDF PubMed Scopus (52) Google Scholar , 10 Topaz O. Bailey N.T. Mohanty P.K. Application of solid-state pulsed-wave mid-infrared laser for percutaneous revascularization in heart transplant recipients. J Heart Lung Transplant. 1998; 17: 505-510 PubMed Google Scholar , 11 Jain S.P. Ventura H.O. Ramee S.R. Collins T.J. Isner J.M. White C.J. Directional atherectomy in heart transplant recipients. J Heart Lung Transplant. 1993; 12: 819-823 PubMed Google Scholar There is virtually no reported experience with coronary interventional procedures in pediatric heart transplant recipients. 4 Pahl E. Zales V.R. Fricker F.J. Addonizzio L.J. Posttransplant coronary artery disease in children. A multicenter national survey. Circulation. 1994; 90: II-56-II-60 Google Scholar This report reviews our experience with coronary interventional procedures in 3 pediatric heart transplant recipients.