Outcome Of Left Main Stenting After Heart Transplantation
Cedars-Sinai Smidt Heart Institute, Los Angeles, CA
Meeting: 2019 American Transplant Congress
Abstract number: B105
Keywords: Heart
Session Information
Session Name: Poster Session B: Heart and VADs: All Topics
Session Type: Poster Session
Date: Sunday, June 2, 2019
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall C & D
*Purpose: Cardiac allograft vasculopathy (CAV) is one of the major factors limiting long-term survival after HTx. The use of angioplasty and drug-eluting stents is common after HTx. CAV of the left main (LM) coronary artery is known to have high mortality risk. The long-term outcome of stenting for LM disease has not been well evaluated in this cohort of patients.
*Methods: Between 2010 and 2013 we assessed 37 heart transplant patients who underwent stenting of the LM coronary artery post-transplant. A non-left main (no LM disease with another coronary artery stented) population was included (n=27) for comparison. Outcomes included 5-year freedom from restenosis (≥50% stent stenosis) subsequent 5-year survival, subsequent 5-year freedom from any myocardial infarction, and subsequent 5-year freedom from further deterioration in left ventricular function by echocardiogram.
*Results: Subsequent 5-year freedom from restenosis and freedom from further deterioration in LV function was significantly lower in the LM stented group (see table). There was no difference in subsequent 5-year survival or freedom from myocardial infarction.
*Conclusions: Patients with left main stenting appear to be have acceptable survival after heart transplantation despite progression to a lower left ventricular function and more restenosis. Alternatives to treatment for significant LM disease such as coronary bypass surgery and re-transplantation are not practical options in this diffuse disease and scarcity of donor hearts.
Endpoints | Left Main Stent (n=37) | Non-LM Stent (n=27) | Log-Rank P-Value |
Subsequent 5-Year Freedom from Restenosis | 81.0% | 88.9% | 0.028 |
Subsequent 5-Year Survival | 60.0% | 69.7% | 0.584 |
Subsequent 5-Year Freedom from Myocardial Infarction | 68.4% | 86.9% | 0.282 |
Subsequent 5-Year Freedom from Further Deterioration in LV Function | 51.5% | 86.4% | 0.031 |
To cite this abstract in AMA style:
Dimbil S, Patel J, Azarbal B, Kittleson M, Levine R, Chang DH, Kobashigawa JA. Outcome Of Left Main Stenting After Heart Transplantation [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/outcome-of-left-main-stenting-after-heart-transplantation/. Accessed December 12, 2024.« Back to 2019 American Transplant Congress