Cardiac allograft vasculopathy Complications and imaging studies

• Published in: Herz Vol. 36; no. 7; pp. 630 - 636
• Main Authors: Di Bella, G., Minutoli, F., Coglitore, S., Recupero, A., Donato, R., Caruso, R., Grimaldi, P., Lentini, S.
• Format: Journal Article
• Language: English
• Published: Munchen Urban and Vogel 01.10.2011
• Subjects: Aged; Cardiology; Case Study; Cicatrix - complications; Cicatrix - diagnosis; Cicatrix - therapy; Comorbidity; Coronary Artery Disease - complications; Coronary Artery Disease - diagnosis; Coronary Artery Disease - therapy; Early Diagnosis; Echocardiography; Heart Ventricles; Humans; Image Processing, Computer-Assisted; Internal Medicine; Magnetic Resonance Imaging, Cine; Male; Medicine; Medicine & Public Health; Myocardial Infarction - complications; Myocardial Infarction - diagnosis; Myocardial Infarction - therapy; Myocardial Ischemia - diagnosis; Myocardial Ischemia - etiology; Myocardial Ischemia - therapy; Pericarditis - diagnosis; Pericarditis - etiology; Pericarditis - therapy; Postoperative Complications - diagnosis; Postoperative Complications - etiology; Postoperative Complications - therapy; Secondary Prevention; Survivors; Thrombosis - diagnosis; Thrombosis - etiology; Myocardial infarction; Myokardinfarkt; Magnetic resonance imaging, cardiac; Herztransplantation; Imaging; Heart transplantation; Bildgebung; Cardiac allograft vasculopathy; Kardiale Allotransplantat-Vaskulopathie; Kardiale Magnetresonanztomographie
• ISSN: 0340-9937; 1615-6692
• DOI: 10.1007/s00059-010-3373-8

Cardiac allograft vasculopathy (CAV) is an accelerated form of coronary artery disease affecting both intramyocardial and epicardial coronary arteries and is observed in patients during long-term survival after cardiac transplantation. We report a case of CAV complicated with silent transmural myocardial infarction and massive left ventricular thrombus formation associated with silent pericarditis and with ischemic and non-ischemic scar tissue, as detected by cardiac magnetic resonance imaging (CMRI). The authors suggest CMRI as an additional technique along with echocardiography during follow-up of heart transplant recipients. CMRI may contribute to the early identification of areas of myocardial wall abnormalities suggestive of CAV, thus guiding diagnosis and prompt percutaneous treatment.