Coronary Artery Vasculopathy in Pediatric Heart Transplant Patients
Status:
Completed
Trial end date:
2011-01-01
Target enrollment:
Participant gender:
Summary
Heart transplantation is a life-sustaining therapy that allows patients with either
congenital or acquired heart disease and severe cardiac dysfunction to survive. Over time,
however, the transplanted heart can develop problems. One of the more common and troubling
problems is the development of stenoses, or narrowings, within the coronary arteries. These
narrowings, technically referred to as coronary artery vasculopathy (CAV for short), account
for the single most common cause of death or need for repeat heart transplant in persons more
than one year post-transplant. Traditionally, CAV has been diagnosed at cardiac
catheterization using coronary angiography (where dye is directly injected into the coronary
blood vessels and viewed using special x-ray equipment called fluoroscopy). There is no good
treatment for CAV aside from treatment of symptoms and listing for repeat heart
transplantation. The goal of this study is to test several newer methods of diagnosing CAV.
The first is called coronary flow reserve (catheterization test). The second is called
Endo-PAT (a finger probe test) and the third is called contrast-enhanced cardiac MRI (MRI
test, only for patients 12 and older). The older method (coronary angiography) will still be
used in all cases, in addition to the new tests The goal is, one day, to be able to diagnose
patients with CAV earlier in the course, prior to a patient's development of abnormal
angiograms. If this can be done, it is possible that better therapies will be able to be used
to stop or even reverse the development of CAV, perhaps reducing, or at least delaying, the
need for repeat heart transplantation.