Lee Michael S, Chun Kook-Jin, Tobis Jonathan M
Division of Cardiology, David Geffen School of Medicine at University of California, Los Angeles, California, USA.
Catheter Cardiovasc Interv. 2008 Feb 15;71(3):306-11. doi: 10.1002/ccd.21370.
To assess the safety and efficacy of percutaneous coronary intervention (PCI) with drug-eluting stents (DES) in orthotopic heart transplantation (OHT) patients with unprotected left main coronary artery (ULMCA) disease.
Accelerated transplant coronary artery disease occurs in 50% of patients at 5 years and is the major cause of death following OHT. The optimal treatment for ULMCA disease in OHT patients is unknown.
From April 2003 to December 2006, five OHT patients with ULMCA disease underwent PCI with DES at the University of California, Los Angeles, Medical Center.
Technical success was achieved in all five patients. At a median follow-up of 518 days (range 124-990 days), all five patients were alive and free from death, myocardial infarction, and target vessel revascularization. No binary restenosis was present in four patients who underwent surveillance angiography. One patient underwent repeat OHT for progressive left ventricular dysfunction.
In OHT patients, ULMCA PCI with DES is feasible with an excellent technical success rate and is a reasonably palliative treatment option for this difficult patient population.
评估药物洗脱支架（DES）经皮冠状动脉介入治疗（PCI）在原位心脏移植（OHT）合并无保护左主干冠状动脉（ULMCA）疾病患者中的安全性和有效性。
50%的患者在5年内会发生加速性移植冠状动脉疾病，这是OHT后死亡的主要原因。OHT患者ULMCA疾病的最佳治疗方法尚不清楚。
2003年4月至2006年12月，5例患有ULMCA疾病的OHT患者在加利福尼亚大学洛杉矶分校医学中心接受了DES PCI治疗。
所有5例患者均取得技术成功。中位随访518天（范围124 - 990天），所有5例患者均存活，无死亡、心肌梗死和靶血管再血管化情况。4例行血管造影监测的患者未出现节段性再狭窄。1例患者因进行性左心室功能障碍接受了再次OHT。
在OHT患者中，DES PCI治疗ULMCA是可行的，技术成功率高，对于这一困难患者群体是一种合理的姑息治疗选择。
