[Echocardiographical features during the rejection free period after heart transplantation: report of one case].

Di Yi Jun Yi Da Xue Xue Bao

Departments of Cardiothoracic Surgery,Nanfang Hospital, First Military Medical University, Guangzhou 510515, China.

Published: August 2002

Objective: To study the echocardiographic features during the period free of acute allograft rejection after heart transplantation by monitoring one patient within one year after heart transplantation.

Methods: The dimension of atrial and ventricular, interventricular septal and ventricular wall thickness, blood flow pattern through the mitral and tricuspid valves, left ventricular muscle weight (LVMW) and LVMW index during different periods were measured by echocardiography, and all these data were compared with those of the donor before operation.

Results: The patient recovered well without any signs of acute rejection. Echocardiography revealed that the dimension of right atrial, left and right ventriculars decreased significantly while left atrial showed significant increase, with obvious increase in the interventricular septal and ventricular wall thickness. LVMW and LVMW index were also significantly increased. The peaks E-and A.wave velocifies of the mitral and tricuspid E peak flow velocity decreased significantly, while the A peak flow velocity of the tricuspid did not undergo any significant changes. Mitral back flow occurred 4 months after the operation and tricuspid back flow persisted after operation.

Conclusions: The changes of morphology, structure and function of the transplanted heart during periods without rejection are to some extent specific to this special phase, when some of these changes are similar to those during early acute rejection, and correct diagnosis relies on endo-myocardial biopsy.

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