Kerber S, Heinemann-Vechtel O, Scheld H H, Schober O, Breithardt G
Medizinische Klinik und Poliklinik/Innere Medizin C, Westfälische Wilhelms-Universität Münster.
Z Kardiol. 1995 Aug;84(8):616-20.
A 23-year-old man underwent orthotopic heart transplantation due to dilative cardiomyopathy, receiving the heart of a 32-year-old donor. Coronary angiography 7 weeks following transplantation revealed a single left coronary artery arising from the left coronary sinus, and as a coronary abnormality the right coronary artery was originating from the proximal left anterior descending branch. Angiographically the single coronary artery showed no stenoses or irregularities. Intravascular ultrasound examination (30 MHz, 3.5-F catheter) demonstrated relevant atherosclerotic lesions along the stem, the proximal and middle portion of the left anterior descending artery, and especially at the origin of the equivalent of the right coronary artery. Thallium-201 stress testing showed only discrete filling defects at the inferior wall. After orthotopic heart transplantation intravascular ultrasound investigation can, in addition to angiography, become extremely relevant especially in heart recipients with a single left coronary artery because vessel wall alterations of the stem and left anterior descending artery may influence the prognosis of these recipients.
一名23岁男性因扩张型心肌病接受了原位心脏移植，供体为一名32岁的心脏。移植后7周的冠状动脉造影显示，一条单一的左冠状动脉发自左冠状窦，作为一种冠状动脉异常，右冠状动脉起源于左前降支近端。血管造影显示，这条单一冠状动脉无狭窄或不规则之处。血管内超声检查（30MHz，3.5F导管）显示，在主干、左前降支近端和中段，尤其是相当于右冠状动脉起源处，存在相关的动脉粥样硬化病变。铊-201负荷试验仅显示下壁有散在的充盈缺损。原位心脏移植后，血管内超声检查除血管造影外，可能极具相关性，尤其是对于有单一左冠状动脉的心脏受者，因为主干和左前降支的血管壁改变可能会影响这些受者的预后。
