A Covered Coronary Stent for Acute Perforation after a Percutaneous Coronary Intervention due to Cardiac Allograft Vasculopathy

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.

Keywords

• Heart transplantation
• Coronary artery disease
• Cardiac allograft vasculopathy
• Percutaneous coronary intervention