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Case reports

Endovascular treatment of an aneurysm of the descending thoracic aorta in a heart transplant recipient: long-term result

^a Department of Cardio-Vascular Surgery, Bordeaux Heart University Hospital, Avenue de Magellan, F. 33 604 Bordeaux-Pessac, France
^b Division of Thoracic and Cardio-Vascular Radiology, Bordeaux Heart University Hospital, France
^c Heart Transplant Unit, Department of Cardio-Vascular Surgery, Bordeaux Heart University Hospital, France

Received 10 August 2007; received in revised form 23 December 2007; accepted 24 December 2007.

^_* Corresponding author. Address: Department of Cardio-Vascular Surgery, Hôpital Haut Lévèque, Avenue de Magellan, 33 604 Bordeaux-Pessac, France. Tel.: +33 5 57 65 64 37; fax: +33 5 57 65 81 57. (Email: louis.labrousse{at}chu-bordeaux.fr).

Heart-transplanted patients have a known higher incidence of aortic aneurysms. However, there is paucity of information regarding thoracic localisation in this clinical setting and of the endovascular option in such patients with chronically high level of immunosuppressive agents. We describe long-term follow-up of a 72-year-old man who developed an aneurysm of the descending part of the thoracic aorta 10 years after an orthotopic cardiac transplantation. Because of comorbid medical conditions, classical open-chest procedure could not be performed. An alternative treatment by endovascular repair was applied successfully and allowed a perfect exclusion of the aneurysm. Chronically high level of immunosuppressive agents seems not to be a contraindication to the endovascular option. Consequently, extended cardiovascular screening of heart-transplanted patients is desirable to facilitate early detection and elective endovascular repair.

Key Words: Thoracic aneurysm • Heart transplant • Stent-graft