Document Detail


Long-term outcomes after percutaneous coronary intervention of left main coronary artery for treatment of cardiac allograft vasculopathy after orthotopic heart transplantation.
MedLine Citation:
PMID:  20920643     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The present study evaluated the safety and efficacy of percutaneous coronary intervention (PCI) of the unprotected left main coronary artery (ULMCA) for the treatment of cardiac allograft vasculopathy (CAV) in consecutive unselected patients with orthotopic heart transplantation (OHT). PCI in patients with OHT and develop CAV has been associated with greater restenosis rates compared to PCI in patients with native coronary artery disease. A paucity of short- and long-term data is available from patients with OHT who have undergone PCI for ULMCA disease. The present retrospective, multicenter, international registry included 21 patients with OHT and CAV who underwent ULMCA PCI from 1997 to 2009. Angiographic success was achieved in all patients. Drug-eluting stents were used in 14 of the 21 patients. No major adverse cardiac events or repeat OHT occurred within the first 30 days. At a mean follow-up of 4.9 ± 3.2 years, 3 patients (14%) had died, myocardial infarction had occurred in 1 patient (5%), and target lesion revascularization had been required in 4 patients (19%). Follow-up angiography was performed in 16 patients (76%), and restenosis was observed in 4 (19%). No stent thrombosis of the ULMCA was observed. One patient (5%) underwent coronary artery bypass grafting, and 5 patients (24%) underwent repeat OHT. In conclusion, the results of our study have shown ULMCA PCI to be safe and reasonably effective in patients with OHT and represents a viable treatment strategy for CAV in these patients.
Authors:
Michael S Lee; Tae Yang; William F Fearon; Michael Ho; Giuseppe Tarantini; Jola Xhaxho; Gino Gerosa; Mark Weston; Ashkan Ehdaie; Leroy Rabbani; Ajay J Kirtane
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study    
Journal Detail:
Title:  The American journal of cardiology     Volume:  106     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-05     Completed Date:  2010-10-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1086-9     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 Elsevier Inc. All rights reserved.
Affiliation:
Division of Cardiology, University of California, Los Angeles, Medical Center, Los Angeles, California, USA. mslee@mednet.ucla.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angioplasty, Transluminal, Percutaneous Coronary / methods
Coronary Angiography
Coronary Artery Disease / mortality,  radiography,  therapy*
Drug-Eluting Stents*
Female
Follow-Up Studies
Graft Rejection
Graft Survival
Heart Failure / surgery
Heart Transplantation / adverse effects*,  methods,  mortality
Humans
Italy / epidemiology
Male
Middle Aged
Retrospective Studies
Severity of Illness Index
Survival Rate
Time Factors
Transplantation, Homologous
Treatment Outcome
United States / epidemiology
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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