OBJECTIVES: The goal of this study was to examine the outcomes of percutaneous coronary interventions (PCI) and the predictors for restenosis after cardiac transplantation. BACKGROUND: The role of PCI as definitive therapy for allograft coronary disease (ACD) remains contentious. METHODS: Between January 1, 1990 and December 31, 2000, 62 patients (1.5 to 15.5 years after transplant) underwent 151 procedures resulting in PCIs of 219 lesions. Follow-up after PCI angiography was usually obtained at three and six months, then yearly. Repeat PCI was routinely done to lesions with >60% restenosis. RESULTS: The primary procedural success was 97%. Repeat PCI occurred in 74 of 219 lesions (34%); PCI-related mortality was 2.6% (4 of 151). The freedom from re-PCI (of same vessel site) was 75% at six months, 65% at one year, and 57% at four years. The freedom from restenosis was 95% at one month, 81% at three months, and 57% at six months. Multivariate predictors of freedom from restenosis were the use of stents, higher anti-proliferative immunosuppressant dose, and an era effect. In the setting of one-vessel disease at first PCI, the two-year freedom for ACD death or graft loss was 74%, compared with 75% for two-vessel and 27% for three-vessel disease (p = 0.009). CONCLUSIONS: Despite the increasing effectiveness of PCI for localized ACD, the survival after development of advanced ACD remains poor. Stents appear to increase effectiveness of PCI for ACD, but other factors in the current era contribute to improved outcomes.
OBJECTIVES: The goal of this study was to examine the outcomes of percutaneous coronary interventions (PCI) and the predictors for restenosis after cardiac transplantation. BACKGROUND: The role of PCI as definitive therapy for allograft coronary disease (ACD) remains contentious. METHODS: Between January 1, 1990 and December 31, 2000, 62 patients (1.5 to 15.5 years after transplant) underwent 151 procedures resulting in PCIs of 219 lesions. Follow-up after PCI angiography was usually obtained at three and six months, then yearly. Repeat PCI was routinely done to lesions with >60% restenosis. RESULTS: The primary procedural success was 97%. Repeat PCI occurred in 74 of 219 lesions (34%); PCI-related mortality was 2.6% (4 of 151). The freedom from re-PCI (of same vessel site) was 75% at six months, 65% at one year, and 57% at four years. The freedom from restenosis was 95% at one month, 81% at three months, and 57% at six months. Multivariate predictors of freedom from restenosis were the use of stents, higher anti-proliferative immunosuppressant dose, and an era effect. In the setting of one-vessel disease at first PCI, the two-year freedom for ACD death or graft loss was 74%, compared with 75% for two-vessel and 27% for three-vessel disease (p = 0.009). CONCLUSIONS: Despite the increasing effectiveness of PCI for localized ACD, the survival after development of advanced ACD remains poor. Stents appear to increase effectiveness of PCI for ACD, but other factors in the current era contribute to improved outcomes.
Authors: Michele Pighi; Fabrizio Tomai; Alessandro Petrolini; Leonardo de Luca; Giuseppe Tarantini; Alberto Barioli; Paola Colombo; Silvio Klugmann; Marco Ferlini; Maurizio Ferrario Ormezzano; Bruno Loi; Paolo Calabrò; Renato Maria Bianchi; Giuseppe Faggian; Alberto Forni; Corrado Vassanelli; Marco Valgimigli; Flavio Ribichini Journal: J Cardiovasc Transl Res Date: 2015-12-18 Impact factor: 4.132
Authors: Joe X Xie; Jon A Kobashigawa; Kevin F Kennedy; Timothy D Henry; Steven W Tabak; Robert Krebbs; Leslee Shaw; J Dawn Abbott; Wendy Book; S Tanveer Rab; John A Spertus; Abhinav Goyal Journal: JAMA Cardiol Date: 2020-06-01 Impact factor: 14.676
Authors: Raymond L Benza; Matthew A Cavender; Joseph Barchue; Jose A Tallaj; Robert C Bourge; James K Kirklin; Christopher S Coffey Journal: J Heart Lung Transplant Date: 2007-05 Impact factor: 10.247
Authors: Franz von Ziegler; Alexander W Leber; Alexander Becker; Ingo Kaczmarek; Ulf Schönermarck; Christine Raps; Janine Tittus; Peter Uberfuhr; Christoph R Becker; Maximilian Reiser; Gerhard Steinbeck; Andreas Knez Journal: Int J Cardiovasc Imaging Date: 2008-07-19 Impact factor: 2.357
Authors: Syed-Saif Abbas Rizvi; Jessica G Y Luc; Jae Hwan Choi; Kevin Phan; Ester Moncho Escrivà; Sinal Patel; H Todd Massey; Vakhtang Tchantchaleishvili Journal: Ann Cardiothorac Surg Date: 2018-01