Safety of optical coherence tomography in pediatric heart transplant patients

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• 作者：Sarah M. Ulrich^a ; ^{Sarah.Ulrich@med.uni-muenchen.de} ; Anja Lehner^a ; Julia Birnbaum^a ; Stefanie Heckel^a ; Nikolaus A. Haas^a ; Lale Hakami^b ; Rene Schramm^b ; Robert Dalla Pozza^a ; Marcus Fischer^a ; Rainer Kozlik-Feldmann^a ; ^c
• 关键词：Pediatric heart transplantation ; Optical coherence tomography ; Cardiac allograft vasculopathy
• 刊名：International Journal of Cardiology
• 出版年：2017
• 出版时间：1 February 2017
• 年：2017
• 卷：228
• 期：Complete
• 页码：205-208
• 全文大小：501 K
• 卷排序：228

文摘

Cardiac allograft vasculopathy (CAV) is a crucial problem after heart transplantation, in adults as well as in children. CAV is the main risk factor for a reduced long-term graft survival. The early diagnosis and treatment of CAV is essential for a successful long-term preservation of the donor heart. However, asymptomatic progression of CAV and concentric hyperplasia of the coronary arteries may complicate the early diagnosis by conventional measures. Intravascular imaging, such as intravascular ultrasound and optical coherence tomography (OCT), enables the diagnosis of early stage CAV. To date, there is little known about OCT in children. We present our single center experience with OCT after pediatric heart transplantation.MethodsRetrospective analysis of OCT (n = 50) after pediatric heart transplantation between June 2013 and March 2016 and comparison between angiographic appearance and OCT.Results37 patients underwent optical coherence tomography, nine patients were examined twice and two patients tree times. The youngest patient at time of examination was 4 years with a weight of 15 kg (mean 50.86 kg, range 15 to 88 kg). There were no complications, especially no bleeding, no arrhythmias or myocardial ischemic events. Early CAV (Stanford I or II) was detected by OCT in 26 cases. Only in four of these cases, also the coronary angiography showed mild changes.ConclusionOCT is a safe intravascular imaging method that can also be used in children after pediatric heart transplantation up to a minimum weight of 15 kg without an increasing risk of a catheterization procedure.