Analysis Of Allograft Arteriopathy After Heart Transplantation

[Objective] To summarize the pathogenic condition of allograft arteriopathy after heart transplantation, study etiology, prevention, diagnosis, therapy, increase the survival rate.[Methods] 15 cases of heart transplantation were reviewed and followed-up clinically. Analysis of statistics and clinic were implemented by index or data of heart transplantation.[Results] All patients have good life quality without any symptoms or smoke or drink. 2 cases hypertention ,2 cases diabetes. cholesterol was high and cytomegalovirus was infected partly. No any acute but chronic rejective manifestation were observed in endomyocardial biopsy samples. Endothelium-dependen vasodilatation was normal. No any myocardial ischemic signs were detected in electrocardiogram. Left ventricular Tc scintigraphy and coronary angiography showed that 6 cases have typical vasculopathy with diffuse stenosis involved all coronary branches to some extent. Coronary angioplasty and stent placement of proximal right coronary was performed in one case. The perfusion of the left ventricular wall was improved by this angioplasty.[conclusion] Allograft arteriopathy after heart transplantation is a kind of chronic rejection which is prone to appear after operation. It is correlated with survival, cholesterol, cytomegalovirus and it has both similarities and differences with native coronary artery disease. Left ventricular Tc scintigraphy and coronary angiography can detect the disease early. Owing to the lacking of effective therapy, how to prevent the development of allograft arteriopathy become more important. Local severe stenosis of coronary after heart transplantation can be treated by coronary stenting. Sometime it is need to transplant heart again but curative effect is dissatisfied.