Hastillo A, Cowley M J, Vetrovec G, Wolfgang T C, Lower R R, Hess M L
J Heart Transplant. 1985 Feb;4(2):192-5.
A 51-year-old man underwent orthotopic heart transplantation for end-stage ischemic cardiomyopathy. Forty-six months after the operation significant coronary artery disease was demonstrated in the allografted heart, with severe (90% to 95%) proximal stenosis of the left anterior descending artery as well as diffuse distal and smaller branch lesions. Percutaneous transluminal coronary angioplasty of the proximal left anterior descending artery lesion was successfully performed, reducing the stenosis to a 20% to 30% narrowing. Sixteen months later, repeated angiography showed sustained improvement of the proximal left anterior descending artery lesion and development of new significant lesions in the mid-left anterior descending and left circumflex coronary arteries. Coronary angioplasty of the mid-left anterior descending and proximal circumflex artery lesions was successfully performed and an angiogram four months later showed continued angiographic improvement at each of the distal sites. This case represents the first reported coronary artery angioplasty in a heart transplant recipient. It demonstrates the successful application of a non-operative myocardial revascularization procedure using percutaneous transluminal coronary angioplasty to achieve sustained palliation of significant coronary artery disease following heart transplantation.
一名51岁男性因终末期缺血性心肌病接受了原位心脏移植。术后46个月，异体移植心脏出现严重冠状动脉疾病，左前降支近端严重狭窄（90%至95%），同时伴有弥漫性远端及较小分支病变。成功对左前降支近端病变进行了经皮腔内冠状动脉成形术，将狭窄程度降至20%至30%。16个月后，重复血管造影显示左前降支近端病变持续改善，而左前降支中段和左旋支冠状动脉出现新的严重病变。成功对左前降支中段和左旋支近端动脉病变进行了冠状动脉成形术，4个月后的血管造影显示每个远端部位的血管造影情况持续改善。该病例是首次报道的心脏移植受者冠状动脉成形术。它展示了经皮腔内冠状动脉成形术这种非手术心肌血运重建程序在心脏移植后成功应用于显著冠状动脉疾病的持续缓解。
