Giant Coronary Aneurysms in Heart Transplantation: an Unusual Presentation of Cardiac Allograft Vasculopathy

Haddad, François; Pérez, Marco; Fleischmann, Dominik; Valantine, Hannah A.; Hunt, Sharon A.

doi:10.1016/j.healun.2006.07.006

Cited by 6 publications

(6 citation statements)

References 13 publications

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“…A variety of other systemic inflammatory conditions have been associated with CAAs, including systemic lupus erythematosus (12)(13)(14)(15), Behçet disease (16,17), ankylosing spondylitis (18), cardiac graft vasculopathy (19,20), granu- lomatosis with polyangiitis (21), eosinophilic granulomatosis with polyangiitis (22), Takayasu arteritis (11,23), immunoglobulin G4 (IgG4)related disease (which more typically causes adventitial masses) (24), and hypergammaglobulinemia E (25). The histopathologic changes in these aneurysms have not been well documented but include acute inflammation with fibrinoid necrosis, thrombosis, and inflammatory destruction of the coronary arterial wall (7,12,20,26).…”

Section: Pathophysiology Of Caasmentioning

confidence: 99%

Spectrum of Coronary Artery Aneurysms:From the Radiologic Pathology Archives

Jeudy¹,

White²,

Kligerman³

et al. 2018

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Advances in medical diagnosis reveal that coronary artery aneurysms (CAAs) may develop in several clinical scenarios and manifest variable symptoms, imaging appearances, and outcomes. Aneurysms are pathologically classified into three groups: atherosclerotic, inflammatory, and noninflammatory. The last category is associated with congenital, inherited, and connective tissue disorders. Overlap exists among the groups, because secondary atherosclerotic change may be present in an aneurysm of any cause. Atherosclerosis is the most common cause of CAAs in adults, and inflammation is considered the underlying mechanism. In children, Kawasaki disease is the most likely cause of CAAs. In both conditions, the aneurysms are usually multiple and affect more than one coronary artery. Mycotic (infectious), iatrogenic, and cocaine-induced CAAs are also well documented. Most CAAs are discovered incidentally, but potential cardiovascular complications include thrombosis, occlusion, fistula formation, rupture, myocardial infarction, and cardiac tamponade. Imaging modalities to evaluate a suspected CAA include transthoracic echocardiography, angiographic cardiac catheterization, electrocardiographically gated computed tomographic angiography, cardiac magnetic resonance (MR) imaging, and MR angiography. Management is usually individualized, and options include surveillance, anticoagulant therapy, percutaneous stent or coil placement, surgical resection, and coronary artery bypass grafting.

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Section: Pathophysiology Of Caasmentioning

confidence: 99%

Spectrum of Coronary Artery Aneurysms:From the Radiologic Pathology Archives

Jeudy¹,

White²,

Kligerman³

et al. 2018

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“…7,8 Less frequently, destruction of elastic fibers and thinning of the muscular media may appear, resulting in vessel wall aneurysms. 2,9,10 More work is still needed, however, to better understand the role of immunosuppressor treatment in the development of graft vasculopathy related to humoral response.…”

mentioning

confidence: 99%

Effects of Cyclosporine, Tacrolimus and Sirolimus on Vascular Changes Related to Immune Response

Rigol

Solanes

Sionís

et al. 2008

The Journal of Heart and Lung Transplantation

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“…Therefore, patients presenting with CD have a good prognosis. However, these forms of CD are not completely harmless, as case studies have reported thrombotic events with consecutive cardiac infarction and also ruptures of the aneurysms (13) (14). We did not find any of these side effects in our study population.…”

Section: Discussionmentioning

confidence: 47%

“…In contrast, endothelialdependent vasodilatation was impaired in the ectatic and nonectatic group, reflecting diffuse endothelial injury after HTx. The pathogenesis of CD is controversially discussed (4,9,14). Several facts suggest that CD is not simply a variant of coronary atherosclerosis (4).…”

Section: Discussionmentioning

confidence: 99%