Cytomegalovirus and graft vascular disease in acute coronary syndrome: case report

Abstract

Introduction: Heart transplantation is the gold standard treatment for severe cases of heart failure. Post-transplantation involves early and late complications, such as rejection and infection, which can lead to graft failure and death. Cytomegalovirus (CMV) infection may increase the risk of developing graft vascular disease, which in turn is one of the factors associated with organ transplant rejection and the occurrence of acute myocardial infarction (AMI). For ischemia reversion, one of the alternatives is the placement of a stent in order to reestablish cardiac flow. Aim: To report the case of a patient who underwent angioplasty with a bioabsorbable stent due to AMI caused by vascular graft disease, in turn due to CMV infection. Case report: Male patient, 42 years old, who underwent transplantation due to major ventricular dysfunction secondary to Chagas' disease. After CMV infection, he developed coronary obstruction and AMI, and was then submitted to the placement of a bioabsorbable stent. Seven months later, he presented a new coronary obstruction, when it was then decided to replace the first stent with a conventional metallic device. Conclusion: In this case, the bioabsorbable stent seems to have facilitated thrombotic obstruction and consequent ischemia, putting in doubt the risk-benefit of its use.