European Journal of Cardio-Thoracic Surgery, Vol 9, 399-402, Copyright © 1995 by European Association for Cardio-thoracic Surgery
Regression of pre-existing coronary artery disease in a donor heart after cardiac transplantation
M Haude, J Ge, A Machraoui, R Erbel and HR Zerkowski
Cardiology Department, University Essen, Germany.
This report is about the angiographic follow-up, over 5 years, in a patient
with urgent heart transplantation grafted with an atherosclerotic donor
heart because of severe congestive heart failure due to dilative
cardiomyopathy. Sequential quantitative angiography documented a regression
of the luminal narrowing of a focal lesion in the right coronary artery
with a minimal luminal diameter of 1.38 mm (56% diameter stenosis) in 1988
to 2.78 mm (13%) in 1993. During this catheterization in 1993 intravascular
ultrasound imaging illustrated almost no atherosclerotic vessel wall
abnormalities at the site of the previous angiographic luminal narrowing as
well as in the adjacent segments. These findings might promote the
potential acceptance of heart transplant donors with a certain extent of
coronary artery disease in the case of urgent organ request, if close
follow-up and strict guidance of the patient by the transplanting team is
feasible.
