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An angiographic study of coronary arterial disease in children after heart transplantation

Published online by Cambridge University Press:  19 August 2008

Ana Ladeia ,
Jérôme Le Bidois ,
Jean François Piéchaud ,
Jean Philippe Metzger ,
Pascal Vouhé  and
Jean Kachaner
Ana Ladeia
Affiliation:
From the Service de Cardiologie Pédiatrique, Hopital Laënnec, Paris
Jérôme Le Bidois*
Affiliation:
From the Service de Cardiologie Pédiatrique, Hopital Laënnec, Paris
Jean François Piéchaud
Affiliation:
From the Service de Cardiologie Pédiatrique, Hopital Laënnec, Paris
Jean Philippe Metzger
Affiliation:
Service de Cardiologie, Hopital Laënnec, Paris
Pascal Vouhé
Affiliation:
Hopital Necker Enfants Malades and the Service de Chirurgie Cardiovasculaire, Hopital Laënnec, Paris
Jean Kachaner
Affiliation:
From the Service de Cardiologie Pédiatrique, Hopital Laënnec, Paris
*
Dr. Jérôme Le Bidois, Service de Cardiologie Pédiatrique, Hopital Necker Enfants Malades, 149, rue de Sèvres, 75015 Paris, France. Tel. (33-1) 44 49 43 42; Fax. (33-1) 44 49 43 40.
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Summary

Coronary angiograms were analyzed in 29 children after heart transplantation. Age at transplantation was one month to 14 years (mean 4.5 years) with follow-up from five months to six years (mean 2.9 years). Immunosuppression was based on cyclosporine and azathioprine; six patients also received maintenance steroids. Coronary angiograms were obtained after giving an intracoronary arterial bolus of nitroglycerin to avoid spasm. Coronary angiograms showed stenoses, luminal irregularities, loss of luminal diameter and obliteration of branches, and one example of myocardial bridging. The review of angiographic recordings in some patients showed a loss of normal motion of coronary arteries which, instead, appeared rigid. No abnormalities were seen in eight patients (28%). Coronary arterial changes were present between six months and four years after transplantation in 15 patients (52%). Isolated loss of normal motion of the coronary arteries was present in six patients (20%). The separate analysis of 15 patients who underwent more than one coronary angiogram showed a progression of lesions in eight cases. Coronary arterial disease is a frequent complication of heart transplantation in children and there is a progression of lesions in a large proportion of patients. Since there is no satisfactory therapy for this complication, heart transplantation should be reserved for children having no other reasonable therapeutic option.

Keywords

Heart transplantationchildrencoronary arterial diseasecoronary angiography
Type
World Forum for Pediatric Cardiology Young Investigator Finalists
Information
Cardiology in the Young , Volume 4 , Issue 1 , January 1994 , pp. 15 - 18
Copyright
Copyright © Cambridge University Press 1994

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