RESUMO
Complete occlusion of the left anterior descending and right coronary arteries developed in a 58-year-old man 2 years after orthotopic heart transplantation. Because of his progressive shortness of breath, reversible myocardial ischemia, and decreasing ejection fraction, aortocoronary bypass was recommended. The operation was performed without complications, and his postoperative ejection fraction improved by more than 58%. In the past, when coronary artery disease developed in cardiac allografts, another transplant procedure was the only treatment option. Because of the limited donor hearts available today, new strategies are necessary for the treatment of cardiac allograft atherosclerosis.
Assuntos
Ponte de Artéria Coronária , Doença da Artéria Coronariana/cirurgia , Transplante de Coração/efeitos adversos , Doença da Artéria Coronariana/etiologia , Humanos , Imunossupressores/uso terapêutico , Masculino , Pessoa de Meia-Idade , Fatores de TempoRESUMO
This is an unusual case report of a patient in whom extensive atherosclerosis of the abdominal and pelvic arterial tree apparently contributed to long-standing infertility. Conception occurred after revascularization. Guidelines are presented for the treatment of infertility with associated vascular disease and for the handling of pregnancy and delivery in the rare patient who has abdominal or pelvic vascular grafts.
