Premium
Percutaneous coronary artery revascularization procedures in pediatric heart transplant recipients: A large single center experience
Author(s) -
Turner Mariel E.,
Addonizio Linda J.,
Richmond Marc E.,
Zuckerman Warren A.,
Vincent Julie A.,
Torres Alejandro J.,
Collins Michael B.
Publication year - 2016
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.26544
Subject(s) - medicine , revascularization , percutaneous , single center , cardiology , percutaneous coronary intervention , artery , surgery , myocardial infarction
Objectives To describe our experience, at a large pediatric heart transplant center, with percutaneous coronary interventions (PCI) for cardiac allograft vasculopathy (CAV). Background: CAV is a leading cause of late graft failure, mortality, and re‐transplantation in pediatric heart transplant (HTx) recipients. Studies of PCI in adult patients have shown some short‐term improvements, but no significant change in long‐term outcomes. There are limited data on PCI for CAV in pediatric patients. We describe the largest single‐center experience to date. Methods: We performed a retrospective chart review of all pediatric HTx recipients who underwent PCI for a diagnosis of CAV from 2005 to 2014. Results: Twenty‐three procedures were performed in 13 patients, at a median age of 16.4 years (range 5.6–21.2) and median time from HTx to first PCI of 8.3 years (range 2.9–20.3). Three cases consisted of angioplasty alone, two cases had bare metal stents implanted, and the remaining 18 had drug‐eluting stents implanted. There was acute procedural success in all but one case, and there was only one procedure‐related complication (rebleeding from access site). During the follow‐up interval (median 10.4 months, range 0.2–111.8), 7/13 patients had repeat PCI performed, two patients died (at 1.8 and 5.8 months post‐PCI), and five were re‐transplanted (range 0.2–18 months post‐PCI). Freedom from death or retransplant by Kaplan–Meier analysis was 54% at 1 year. Conclusions: PCI can be performed safely and effectively in pediatric HTx recipients with CAV. Similar to the adult experience, there remains a high rate of disease progression and graft failure. © 2016 Wiley Periodicals, Inc.