Cardiac Allograft Vasculopathy (CAV)
What is CAV?
CAV is a form of chronic rejection that narrows the blood vessels of your transplanted heart. We check for CAV by doing a yearly cardiac cath and dobutamine echocardiogram. CAV affects the entire length of the vessel, not just one spot. CAV is not caused by plaque, but rather the vessel wall grows in thickness, leaving less room for blood to pass through. It may come on quickly. As a rule, collateral or smaller natural bypass vessels do not form. The use of stents or bypass surgery is vry difficult and often not possible. For this reason frequent monitoring and preventive care is the best management for CAV.
Who is at risk for CAV?
All heart transplant patients are at risk for CAV. CAV affects men and women, adults and children of all races who have had heart transplants. CAV can occur early after transplant, but the frequency increases over time after transplant.
What can we do to prevent CAV?
Manage your risk factors that you can change.
- Lower your cholesterol.
- Control your diabetes.
- Manage your blood pressure.
- Watch your weight.
Take your immunosuppressant medicines as prescribed.
- Because CAV is a form of rejection, it is vital to take all of your immunosuppressant medicines as prescribed.
- CAV is more likely in persons who have had more acute rejections.
- Take “statin” drugs even if you do not have high cholesterol. They work in such a way that they may decrease the risk of CAV.
- Sirolimus; a drug that prevents rejection and also works to prevent CAV, may be added to your treatment if you get CAV. It has been shown to decrease the risks of CAV.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 07/21/2011
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