A COVERED CORONARY STENT FOR ACUTE PERFORATION AFTER A PERCUTANEOUS CORONARY INTERVENTION DUE TO CARDIAC ALLOGRAFT VASCULOPATHY

TL;DR

This paper presents a case where a covered coronary stent was used to treat a complication during a procedure for heart transplant patients with a specific artery disease.

Contribution

The novel aspect is the use of a covered stent to manage a coronary perforation in a heart transplant patient with CAV.

Findings

PCI for CAV can lead to complications like coronary perforation.

A covered stent was successfully used to treat the perforation in this case.

This approach may offer an alternative to re-transplantation in selected patients.

Abstract

Cardiac allograft vasculopathy (CAV) is diffuse concentric narrowing caused by intimal fibriproliferation of the coronary arteries in patients after heart transplantation (HTx). It affects almost one third of patients over the period of 5 years, and more than 50% after 10 years following HTx and remains a common cause of late graft failure and mortality. Percutaneous coronary intervention (PCI) can be attempted for focal disease preferably with drug-eluting stents, but the only definite solution is re-transplantation reserved for selected patients with severe CAV. We report a case of a 33- year-old patient with a newly diagnosed CAV, in which a PCI of circumflex coronary artery was attempted, resulting in a coronary perforation treated by the placement of a covered single stent.

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