Outcomes after percutaneous coronary artery revascularization procedures for cardiac allograft vasculopathy in pediatric heart transplant recipients: A multi-institutional study

Jeewa, A.; Chin, C.; Pahl, E.; Atz, A. M.; Carboni, M. P.; Pruitt, E.; Naftel, D. C.; Rodriguez, R.; Dipchand, A. I.

J Heart Lung Transplant. 2015 Jan 13; 34(9):1163-8

Abstract

BACKGROUND: Cardiac allograft vasculopathy is an important cause of long-term graft loss. In adults, percutaneous revascularization procedures (PRPs) have variable success with high restenosis rates and little impact on graft survival. Limited data exist in pediatric recipients of transplants. METHODS: Data from the Pediatric Heart Transplant Study (PHTS) were used to explore associations between PRPs and outcomes after heart transplant in patients listed 30 years old were found to have less freedom from the need for a revascularization procedure than patients with transplants from younger donors (p < 0.0001). CONCLUSIONS: In this large pediatric heart transplant cohort, use of PRPs for cardiac allograft vasculopathy was rare, likely related to procedural feasibility of the interventions. Despite technically successful interventions, graft loss occurred in 39% within 1 year post-procedure; relisting for heart transplant should be considered.

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