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  • Title: [Single left coronary artery after orthotopic heart transplantation: angiography and intravascular ultrasound findings].
    Author: Kerber S, Heinemann-Vechtel O, Scheld HH, Schober O, Breithardt G.
    Journal: Z Kardiol; 1995 Aug; 84(8):616-20. PubMed ID: 7571768.
    Abstract:
    A 23-year-old man underwent orthotopic heart transplantation due to dilative cardiomyopathy, receiving the heart of a 32-year-old donor. Coronary angiography 7 weeks following transplantation revealed a single left coronary artery arising from the left coronary sinus, and as a coronary abnormality the right coronary artery was originating from the proximal left anterior descending branch. Angiographically the single coronary artery showed no stenoses or irregularities. Intravascular ultrasound examination (30 MHz, 3.5-F catheter) demonstrated relevant atherosclerotic lesions along the stem, the proximal and middle portion of the left anterior descending artery, and especially at the origin of the equivalent of the right coronary artery. Thallium-201 stress testing showed only discrete filling defects at the inferior wall. After orthotopic heart transplantation intravascular ultrasound investigation can, in addition to angiography, become extremely relevant especially in heart recipients with a single left coronary artery because vessel wall alterations of the stem and left anterior descending artery may influence the prognosis of these recipients.
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