Genoud J L, Delahaye F, Boissonnat P, Ninet J, Loire R, André-Fouët X, Delaye J
Hôpital cardiovasculaire et pneumologique Louis-Pradel, Lyon.
Arch Mal Coeur Vaiss. 1992 Sep;85(9):1357-60.
Accelerated atherosclerosis of cardiac grafts is one of the factors limiting long-term survival after cardiac transplantation. The authors report the case of a patient who had a cardiac arrest associated with severe atherosclerosis 18 months after transplantation. The severity of the coronary lesions was underestimated by coronary angiography. An ergometrine test induced coronary spasm, a phenomenon which has only rarely been observed in transplanted hearts. The patient died one month later despite calcium inhibitor therapy. Autopsy revealed very severe triple vessel disease. This case illustrates the possible rapid evolution of coronary artery disease in cardiac transplant recipients, the difficulty in evaluating the severity of the lesions by coronary angiography and the additional possibility of observing coronary spasm in these cases.
心脏移植血管加速动脉粥样硬化是限制心脏移植术后长期存活的因素之一。作者报告了1例患者，该患者在心脏移植18个月后发生心脏骤停，伴有严重动脉粥样硬化。冠状动脉造影低估了冠状动脉病变的严重程度。麦角新碱试验诱发了冠状动脉痉挛，这种现象在移植心脏中很少见。尽管进行了钙拮抗剂治疗，患者1个月后仍死亡。尸检显示存在非常严重的三支血管病变。该病例说明了心脏移植受者冠状动脉疾病可能迅速进展，通过冠状动脉造影评估病变严重程度存在困难，以及在这些病例中观察到冠状动脉痉挛的额外可能性。
