Vasculopathy of cardiac allografts is a major therapeutic challenge,occurring in 50 percent or more of heart-transplant recipientsin the first several years after surgery. Improving survivalfor these patients will require the use of new strategies toprevent this relentlessly progressive complication. Allograftvasculopathy involves diffuse narrowing and occlusion of thecoronary arteries, rather than the more focal lesions of conventionalatherosclerosis (see Figure).1 The addition of intravascularultrasonography to standard coronary angiography increases thesensitivity of the procedure for diagnosis and provides a concentricview of the vessel under study.
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Typical Atherosclerosis and Allograft Vasculopathy.
From the Department of Infectious Disease and Transplant Center, Cleveland Clinic Foundation, Cleveland.
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