Şeref Alp KÜÇÜKER, Kemal ARDA, Mehmet Ali ÖZATİK, Erol ŞENER, Aslıhan KÜÇÜKER

Kalp nakli alıcılarında allogreft vaskülopatinin bilgisayarlı tomografi koroner anjiyografi ile değerlendirilmesi

Amaç: Bu çalışmada kalp nakli yapılmış hastalarda bilgisayarlı tomografi (BT) koroner anjiyografinin allogreft vaskülopati tanısındaki etkinliği araştırıldı. Çalışma planı: Kalp nakli sonrası iki yılını doldurmuş ve son üç ay içerisinde kontrol koroner anjiyografisi yapılmış 10 hasta (9 erkek, 1 kadın; ort. yaş 41±9.2 yıl; dağılım 17-59 yıl) çalışmaya alındı. Bu hastalara BT koroner anjiyografi yapıldı. Tüm hastaların standart anjiyografileri aynı araştırmacı tarafından değerlendirildi. A rdından BT koroner anjiyogramlar, bu değerlendirmelerden habersiz ikinci bir araştırmacı tarafından değerlendirdi. Her iki değerlendirme sonucu, üçüncü bir araştırmacı tarafından karşılaştırıldı.Bulgular: Bilgisayarlı tomografi koroner anjiyografide sekiz hastada önemli bir patoloji gözlenmezken, iki hastada sol ön inen koroner arterde yaklaşık %50’lik darlık saptadı. Standart koroner anjiyografide de aynı hastalarda aynı yerleşimde ve benzer oranda sol ön inen koroner arter lezyonları saptandı. Tüm hastalarda standart koroner anjiyografi ve BT koroner anjiyografi sonuçları birbiriyle uyumluydu.Sonuç: Bilgisayarlı tomografi koroner anjiyografi daha az invaziv olup, hasta için daha az risk taşımaktadır. Uygulama kolaylığı ve etkin maliyet gibi bazı avantajlara da sahiptir. Hastaneye yatış gerektirmez. Kalp nakli alıcılarında koroner allogreft vaskülopatinin rutin takibinde BT koroner anjiyografi, standart koroner anjiyografiye alternatif olarak kullanılabilir.

Evaluation of allograft vasculopathy by computed tomography coronary angiography in cardiac transplant recipients

Background: This study aims to investigate the efficacy of computed tomography (CT) coronary angiography for the diagnosis of allograft vasculopathy. Methods: Ten patients (9 males, 1 female; mean age 41±9.2 years; range 17 to 59 years) with a two-year follow-up after cardiac transplant who underwent control coronary angiography within the past three months were enrolled in this study. Computed tomography coronary angiography was performed on these patients. Standard angiographies of all patients were assessed by the same investigator. The BT coronary angiograms were assessed by another investigator who was blind to the previous assessment. Both assessment reports were compared by a third investigator.Results: Eight patients had no major pathological findings with CT coronary angiography, whereas two patients had approximately 50% stenosis on the left anterior descending artery. Standard coronary angiography showed similar left anterior descending artery lesions at the same location in the same patients. The results of the standard coronary angiographies and the CT coronary angiographies were consistent for all patients.Conclusion: Computed tomography angiography is less invasive and has lower risk for the patient. It has also some advantages including easy-to-use and cost-efficacy. Hospitalization is not required. Computed tomography coronary angiography may be an alternative to standard coronary angiography for the routine follow-up of allograft vasculopathy in cardiac transplant recipients.

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