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Transplant coronary artery vasculopathy (TCAV), also known as cardiac allograft vasculopathy or graft vasculopathy, is a serious complication that can arise after heart transplantation. It involves the narrowing and hardening of the coronary arteries, the vessels that supply blood to the heart, leading to a range of cardiovascular problems. This guide aims to provide a comprehensive understanding of TCAV, from its causes and pathogenesis to its diagnosis, treatment, and prevention.
Heart transplantation is a life-saving procedure for patients with end-stage heart failure. However, the success of transplantation is often challenged by the development of transplant coronary artery vasculopathy (TCAV), a chronic vascular disease affecting the coronary arteries of the transplanted heart. TCAV is a major cause of morbidity and mortality after heart transplantation, contributing to graft dysfunction, heart failure, and even death.
The incidence of TCAV is significant, affecting a substantial proportion of heart transplant recipients. Studies have shown that approximately 50% of patients will develop TCAV within 5 years of transplantation, and the prevalence increases with time. While significant progress has been made in understanding the mechanisms underlying TCAV and developing strategies for its management, it remains a complex and challenging clinical problem.