Abstract:
OBJECTIVES:This study sought to analyze the outcomes of revascularization procedures in the treatment of allograft coronary disease. BACKGROUND:Allograft vasculopathy is the main factor limiting survival of heart transplant recipients. Because no medical therapy prevents allograft atherosclerosis, and retransplantation is associated with suboptimal allograft survival, palliative coronary revascularization has been attempted. METHODS:Thirteen medical centers retrospectively analyzed their complete experience with percutaneous transluminal coronary angioplasty, directional coronary atherectomy and coronary bypass graft surgery in allograft coronary disease. RESULTS:Sixty-six patients underwent coronary angioplasty. Angiographic success (< or = 50% residual stenosis) occurred in 153 (94%) of 162 lesions. Forty patients (61%) are alive without retransplantation at 19 +/- 14 (mean +/- SD) months after angioplasty. The consequences of failed revascularization were severe. Two patients sustained periprocedural myocardial infarction and died. Angiographic restenosis occurred in 42 (55%) of 76 lesions at 8 +/- 5 months after angioplasty. Angiographic distal arteriopathy adversely affected allograft survival. Eleven patients underwent directional coronary atherectomy. Angiographic success occurred in 9 (82%) of 11 lesions. Two periprocedural deaths occurred. Nine patients are alive without transplantation at 7 +/- 4 months after atherectomy. Bypass graft surgery was performed in 12 patients. Four patients died perioperatively. Seven patients are alive without retransplantation at 9 +/- 7 months after operation. CONCLUSIONS:Coronary revascularization may be an effective palliative therapy in suitable cardiac transplant recipients. Angioplasty has an acceptable survival in patients without angiographic distal arteriopathy. Because few patients underwent atherectomy and coronary bypass surgery, assessment of these procedures is limited. Angiographic distal arteriopathy is associated with decreased allograft survival in patients requiring revascularization.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Halle AA 3rd,DiSciascio G,Massin EK,Wilson RF,Johnson MR,Sullivan HJ,Bourge RC,Kleiman NS,Miller LW,Aversano TRdoi
10.1016/0735-1097(95)00124-isubject
Has Abstract,Author List Incompletepub_date
1995-07-01 00:00:00pages
120-8issue
1eissn
0735-1097issn
1558-3597pii
073510979500124Ijournal_volume
26pub_type
杂志文章,多中心研究abstract:OBJECTIVES:We evaluated the prevalence and prognostic significance of transient myocardial ischemia despite beta-adrenergic blockade in patients with coronary artery disease. BACKGROUND:Persistence of transient ischemia despite therapy may correspond to a subset of high risk patients with coronary disease. The impact ...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1996-06-01 00:00:00
abstract:OBJECTIVES:This study aimed to clarify the role of the angiotensin-converting enzyme (ACE) gene polymorphism in the development of in-stent restenosis. BACKGROUND:In-stent restenosis occurs after treatment of coronary artery stenosis in 12% to 32% of coronary interventions with stents. Experimental and clinical studie...
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abstract::In remote ischemic conditioning (RIC), brief, reversible episodes of ischemia with reperfusion in one vascular bed, tissue, or organ confer a global protective phenotype and render remote tissues and organs resistant to ischemia/reperfusion injury. The peripheral stimulus can be chemical, mechanical, or electrical and...
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pub_type: 杂志文章,评审
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更新日期:2015-01-20 00:00:00
abstract::Forty-two defibrillating lead systems for the automatic implantable defibrillator were implanted and tested in 41 patients. Two basic lead configurations were used: 1) spring-patch, consisting of a transvenous superior vena cava spring electrode as the anode and an apical or left lateral ventricular patch electrode (e...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(85)80219-9
更新日期:1985-12-01 00:00:00
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更新日期:2014-06-24 00:00:00
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更新日期:2018-04-03 00:00:00
abstract:OBJECTIVES:The effect of dipyridamole on smooth muscle cell proliferation and prevention of intimal thickening after arterial injury was investigated. BACKGROUND:In addition to antiplatelet activity, dipyridamole also inhibits cell proliferation. We examined whether the antiproliferative action of dipyridamole on smoo...
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更新日期:1994-03-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to compare the 3-year efficacy and safety of biodegradable polymer with permanent polymer stents and of everolimus-eluting stents (EES) with sirolimus-eluting stents (SES). BACKGROUND:Biodegradable polymer drug-eluting stents (DES) offer potential for enhanced late outcomes in comp...
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2011-09-20 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2007-05-29 00:00:00
abstract:OBJECTIVES:To explore whether the use of snuff affects the risk of myocardial infarction (MI). BACKGROUND:Snuff and other forms of smokeless tobacco are widely used in some populations. Possible health hazards associated with the use of smokeless tobacco remain controversial. METHODS:In a population-based study withi...
journal_title:Journal of the American College of Cardiology
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更新日期:1999-11-15 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2007.06.042
更新日期:2007-10-09 00:00:00
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更新日期:2011-01-25 00:00:00
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pub_type: 临床试验,杂志文章,多中心研究
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更新日期:2002-06-05 00:00:00
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更新日期:1999-07-01 00:00:00
abstract::In a previous study, a significant inverse relation was found between the luminal size of aortocoronary venous bypass grafts and the vascular resistance of the coronary region that was perfused by the bypass graft in late stages after bypass surgery. This observation suggested that changes in the graft-dependent vascu...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(87)80153-5
更新日期:1987-07-01 00:00:00
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更新日期:2013-04-09 00:00:00
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更新日期:2001-11-01 00:00:00
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更新日期:2013-07-30 00:00:00
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更新日期:2010-04-20 00:00:00
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pub_type: 杂志文章
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更新日期:2015-06-16 00:00:00
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更新日期:2013-04-23 00:00:00
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更新日期:2018-09-18 00:00:00
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更新日期:1999-01-01 00:00:00
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pub_type: 杂志文章,实务指引,评审
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更新日期:2006-10-03 00:00:00
abstract:OBJECTIVES:This study sought to assess the long-term predictive value and net reclassification for risk of cardiovascular disease (CVD) of biomarkers reflecting oxidation-specific epitopes (OSEs). BACKGROUND:OSEs are immunogenic, proinflammatory, and proatherogenic. The long-term predictive value and net reclassificat...
journal_title:Journal of the American College of Cardiology
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更新日期:2012-11-20 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
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更新日期:1989-02-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to examine the effect of intracoronary radiation therapy (IRT) in diabetic patients with in-stent restenosis (ISR). BACKGROUND:Diabetic patients are at an increased risk for restenosis, repeat revascularization procedures and late mortality after percutaneous coronary intervent...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
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更新日期:2002-06-19 00:00:00
abstract:BACKGROUND:Limited intimal tears (LITs) of the aorta (Class 3 dissection variant) are the least common form of aortic pathology in patients presenting with acute aortic syndrome (AAS). LITs are difficult to detect on imaging and may be underappreciated. OBJECTIVES:This study sought to describe the frequency, pathology...
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更新日期:2018-06-19 00:00:00
abstract:OBJECTIVES:This study sought to determine the incidence of aspirin nonresponsiveness in addition to clopidogrel nonresponsiveness and whether this association identifies patients at an increased risk of drug-eluting stent (DES) thrombosis. BACKGROUND:Nonresponsiveness to clopidogrel is a predictor of DES thrombosis. N...
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pub_type: 临床试验,杂志文章
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更新日期:2008-08-26 00:00:00