Open AccessPercutaneous coronary intervention for coronary allograft vasculopathy with drug-eluting stent in Indian subcontinent: Issues in diagnosis and management
Author(s) -
M.S. Alam,
Arvind Sahadev Singh,
Sreeja Pavithran,
Vijayakumar Subban,
Ajit S. Mullasari,
Kothandam Sivakumar
Publication year - 2020
Publication title -
annals of pediatric cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.292
H-Index - 19
eISSN - 0974-2069
pISSN - 0974-5149
DOI - 10.4103/apc.apc_69_19
Subject(s) - medicine , intravascular ultrasound , culprit , acute coronary syndrome , percutaneous coronary intervention , cardiology , stent , angioplasty , drug eluting stent , sudden cardiac death , radiology , myocardial infarction
Coronary allograft vasculopathy fails to give a warning anginal pain due to denervation and often presents with acute coronary syndrome, ventricular dysfunction, or sudden cardiac death. Early diagnosis in a pediatric patient is difficult as it involves invasive coronary angiography or advanced imaging such as intravascular ultrasound or optical coherence tomography. A 12-year-old boy developed acute coronary syndrome, elevated troponins, and right bundle branch block, 5 years after cardiac transplantation and was treated with culprit-vessel angioplasty with a drug-eluting stent. Advanced imaging showed the involvement of nonculprit vessels too. In a detailed literature search, we failed to identify a similar clinical presentation and management in the subcontinent, hence our interest in publishing this report for educational value. Issues in diagnosis, management, prognosis, and prevention are discussed.