Pulmonary Artery Stenosis After an Orthotopic Heart Transplantation: A Case Report With Cardiac Imaging Findings and a Literature Review

TL;DR

This case report describes a rare case of pulmonary artery stenosis occurring more than a decade after a heart transplant, highlighting the role of advanced cardiac imaging in diagnosis.

Contribution

The novelty lies in presenting a rare delayed complication of heart transplantation and demonstrating the utility of advanced MRI techniques in its diagnosis.

Findings

Pulmonary artery stenosis was diagnosed over 10 years post-heart transplant using dynamic cardiac MRI and MR angiography.

Phase contrast imaging and MR angiography provided detailed functional and anatomical evaluation of the pulmonary circulation.

Current multichannel coils enabled precise cardiac imaging for accurate diagnosis and management.

Abstract

Pulmonary artery stenosis is a rare complication of heart transplantation. It is typically a congenital condition or can be secondary to rheumatic fever, systemic vasculitis like Behcet’s disease, or Takayasu’s arteritis. It can also occur as a rarity of a delayed complication post-heart transplant. In this report, we describe the imaging findings of pulmonary artery stenosis in a patient who underwent an orthotopic heart transplant more than 10 years prior. Dynamic cardiac magnetic resonance imaging (MRI), phase contrast imaging, and MR angiography in the management of pulmonary artery stenosis helped in heart and pulmonary circulation. Functional evaluation can be achieved with current multichannel transmit-receive coils. Cardiac gated pre- and dynamic contrast-enhanced MR was performed with phase-contrast imaging for further evaluation confirming the diagnosis of pulmonary artery stenosis.

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