scholarly journals A case of coronary artery air embolism in a transplanted heart during cardiac allograft vasculopathy surveillance angiography

2021 ◽  
Vol 2021 (3) ◽  
Author(s):  
Jeffrey F Spindel ◽  
Vikas Singh ◽  
Mohammad Mathbout
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Rare Complication ◽  
Invasive Coronary Angiography ◽  
Air Embolism ◽  
Acute Chest Pain ◽  
Cardiac Allograft Vasculopathy ◽  
Cardiac Allograft ◽  
Allograft Vasculopathy ◽  
St Segment Elevation

Coronary air embolism is a rare iatrogenic complication during invasive coronary angiography or angioplasty that can cause acute chest pain, hypotension, ST-segment elevation myocardial infarction, and even death. We present a case of left anterior descending coronary artery air embolization in a 58-year-old heart transplant patient that occurred during cardiac allograft vasculopathy surveillance angiography. The patient was managed successfully with rapid coronary injections of heparinized saline, catheter disengagement to increase coronary blood flow, and supplementation of 100% oxygen to dissolve the coronary air embolus. This case highlights this rare complication of coronary angiography, importance of prompt recognition of the pathology and subsequent management.

CORONARY ARTERY STENTING FOR THE TREATMENT OF CARDIAC ALLOGRAFT VASCULOPATHY

1999 ◽  
Vol 67 (7) ◽  
pp. S106
Author(s):  
Christophe Tron ◽  
Michel Redonnet ◽  
René Koning ◽  
François Bouchart ◽  
Hélène Eltchaninoff ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Cardiac Allograft Vasculopathy ◽  
Cardiac Allograft ◽  
Allograft Vasculopathy ◽  
Coronary Artery Stenting

Coronary computed tomography in heart transplant patients: detection of significant stenosis and cardiac allograft vasculopathy, image quality, and radiation dose

2017 ◽  
Vol 59 (9) ◽  
pp. 1066-1073 ◽  
Author(s):  
Anne Günther ◽  
Lars Aaberge ◽  
Andreas Abildgaard ◽  
Asgrimur Ragnarsson ◽  
Thor Edvardsen ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Image Quality ◽  
Radiation Dose ◽  
Heart Transplant ◽  
Cardiac Allograft Vasculopathy ◽  
Cardiac Allograft ◽  
Allograft Vasculopathy ◽  
Significant Stenosis ◽  
Coronary Computed Tomography

Background Cardiac allograft vasculopathy (CAV) is an accelerated form of atherosclerosis unique to heart transplant (HTX) patients. Purpose To investigate the detection of significant coronary artery stenosis and CAV, determinants of image quality, and the radiation dose in coronary computed tomography angiography (CCTA) of HTX patients with 64-slice multidetector CT (64-MDCT). Material and Methods Fifty-two HTX recipients scheduled for invasive coronary angiography (ICA) were prospectively enrolled and underwent CCTA before ICA with intravascular ultrasound (IVUS). Results Interpretable CCTA images were acquired in 570 (95%) coronary artery segments ≥2 mm in diameter. Sensitivity, specificity, and positive and negative predictive values of CCTA for the detection of segments with significant stenosis (lumen reduction ≥50%) on ICA were 100%, 98%, 7.7%, and 100%, respectively. Twelve significant stenoses were located in segments with uninterpretable image quality or vessel diameter <2 mm; only one was eligible for intervention. IVUS detected CAV (maximal intimal thickness ≥0.5 mm) in 33/41 (81%) patients; CCTA and ICA identified CAV (any wall or luminal irregularity) in 18 (44%) and 14 (34%) of these 33 patients, respectively. The mean estimated radiation dose was 19.0 ± 3.4 mSv for CCTA and 5.7 ± 3.3 mSv for ICA ( P < 0.001). Conclusion CCTA with interpretable image quality had a high negative predictive value for ruling out significant stenoses suitable for intervention. The modest detection of CAV by CCTA implied a limited value in identifying subtle CAV. The high estimated radiation dose for 64-MDCT is of concern considering the need for repetitive examinations in the HTX population.

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