Medizinische Universität Graz - Research portal
Selected Publication:
Gasser, R; Koppel, H; Luha, O; Brussee, H; Stoschitzky, K; Tscheliessnigg, KH; Klein, W.
Segmental degradation of left ventricular wall motion after persistent coronary fistula in a posttransplantation patient: a case report and short review of literature.
Transplantation. 2000; 69(10):2108-2111
Doi: 10.1097%2F00007890-200005270-00024
(- Case Report)
Web of Science
PubMed
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FullText_MUG
- Leading authors Med Uni Graz
- Gasser Robert
- Co-authors Med Uni Graz
- Brussee Helmut
- Köppel Herwig
- Stoschitzky Kurt
- Tscheliessnigg Karlheinz
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- Abstract:
- A 50-year-old man received an orthotopic heart transplant because of severe coronary heart disease and congestive heart failure. Two years after the transplantation, a continuous murmur occurred at the left sternal edge after repeated endomyocardial biopsies. Echocardiography and coronary angiography revealed a dilated left anterior descending artery with a fistula to the right ventricle. The circumflex was large with an equally postero-lateral branch, and the right coronary artery was rather small with collaterals to the distal part of the left anterior descending branch. The patient had refused any intervention to close the fistula. The left ventricular levogram was normal. Two years later, in a follow-up angiogram, the left ventricular ejection fraction had decreased as a result of hypo- and akinesis of the apex and posterior wall. We suggest that this local wall motion disturbance derives from a steal phenomenon rather than being a sequela of rejection. The decrease in left ventricular ejection fraction was associated with shortness of breath upon moderate exercise. Standard heart failure medication relieved the patient's symptoms. The observation of local wall motion disturbances in this case, as well as conflicting views in the literature, raises the question whether postbiopsy coronary fistulas in transplant patients should be closed.
- Find related publications in this database (using NLM MeSH Indexing)
- Angiotensin-Converting Enzyme Inhibitors - therapeutic use
- Coronary Angiography - therapeutic use
- Coronary Disease - physiopathology
- Digitalis - therapeutic use
- Echocardiography - therapeutic use
- Follow-Up Studies - therapeutic use
- Heart Catheterization - therapeutic use
- Heart Failure - drug therapy
- Heart Transplantation - drug therapy
- Heart Ventricles - drug therapy
- Humans - drug therapy
- Male - drug therapy
- Middle Aged - drug therapy
- Phytotherapy - drug therapy
- Plants, Medicinal - drug therapy
- Plants, Toxic - drug therapy
- Postoperative Complications - drug therapy
- Vascular Fistula - physiopathology
- Ventricular Dysfunction, Left - etiology
- Ventricular Function, Right - etiology