Coronary Arteriography in Long-Term Human Cardiac Transplantation Survivors

Coronary arterial lesions in survivors of cardiac transplantation result from accelerated coronary atherosclerosis. Clinical recognition of this event is difficult but essential for long-term management and prognostication. Coronary arteriography was performed on 30 occasions in a group of 16 patients 1-4 years after cardiac transplantation. Fifteen patients had normal coronary arteries at one year. Of 10 patients studied at two years, seven showed no change but three others revealed significant coronary arterial lesions which correlated well with clinical signs of coronary artery disease. These three patients subsequently died, two due to coronary artery disease, one due to infection. Three patients have remained normal at three years and one patient is normal at four years as evidenced on yearly coronary arteriograms. A postmortem examination of the patients who died with coronary artery disease confirmed the extent of the luminal narrowing due to atheromatous plaques superimposed on intimal lesions. Coronary arteriography has proven to be a safe, reliable method for assessing the coronary circulation of long-term cardiac transplant survivors.