Desruennes M, Drobinski G, Chomette G, Autran B, Pavie A, Léger P, Gandjbakhch I, Jault F, Grosgogeat Y, Cabrol C
Service de Chirurgie cardiovasculaire, Hôpital de la Pitié, Paris.
Presse Med. 1992 Apr 11;21(14):670-5.
Graft coronary disease is a frequent and devastating complication with rapid development after heart transplantation. Until now, non-invasive and invasive methods have proved to be insensitive in the prediction and detection of the early stages of this disease. Conventional arteriography is considered as the only reliable means of diagnosis, but it remains insensitive in the accurate evaluation of the severity of graft coronary lesions (obliterative, diffuse and distal lesions). Precise quantitation of coronary lumen changes may be a sensitive method for the accurate evaluation of graft coronary disease and help in the understanding of the natural course of development of this disease. The pathogenesis of the disease is still unclear. It is possible that graft coronary disease is a consequence of non-treated low-grade cellular rejections. In most cases, retransplantation must be considered as the unique solution.
移植后冠心病是心脏移植后常见且严重的并发症，发展迅速。到目前为止，无创和有创方法在预测和检测该疾病早期阶段时均显示出不敏感性。传统血管造影被认为是唯一可靠的诊断方法，但在准确评估移植冠状动脉病变（闭塞性、弥漫性和远端病变）的严重程度方面仍然不敏感。冠状动脉管腔变化的精确量化可能是准确评估移植后冠心病的一种敏感方法，并有助于了解该疾病的自然发展过程。该疾病的发病机制仍不清楚。移植后冠心病可能是未治疗的低度细胞排斥反应的结果。在大多数情况下，再次移植必须被视为唯一的解决办法。
