Routine Coronary Angiography in Patients Candidate for Lung Transplantation: A Single Center Data

Background:

Lung transplantation is a high cardiac risk procedure and patients with Chronic Lung Disease (CLD) in general have wide range of cardiovascular risk factors. In our center, these patients undergo routine coronary angiography as part of the cardiac pre-surgical and lung transplantation candidacy evaluation process.

Objectives:

Our study aimed to evaluate Coronary Artery Disease (CAD) in CLD patients and their outcome after routine coronary angiography and Percutaneous Coronary Intervention (PCI).

Methods:

The study included 461 consecutive patients who were deemed candidates for lung transplantation and had undergone routine coronary angiography at our catheterization laboratory. Outcomes of all-cause mortality, target vessel revascularization and cerebrovascular disease are reported in the follow up period of 7 years (mean 23.5±19.2 months) for the PCI group.

Results:

Of the 461 patients included, only 47 (10.2%) were found to have obstructive coronary artery disease and had undergone percutaneous coronary intervention (PCI).

Mean age of the PCI group was 64.8±6.5 years. Eleven (23.4%) patients were females. Patients in the PCI group had more risk factors: 42.2% had diabetes mellitus, 62.2% had hypertension and 33.3% were smokers. At the end of the follow up period, 11 (23.4%) of the patients died, 1 patient (2.1%) suffered a cerebrovascular accident and 1 patient (2.1%) had target vessel revascularization (TVR).

Conclusion:

According to our data, coronary angiography prior to lung transplantation shows low benefit when it is performed routinely as small group of patients have obstructive CAD and it should be offered for patients with high pre-test probability and/or positive non-invasive tests for ischemia.