ABSTRACT
This chapter presents a case study of a 57-year-old white man who had had a heart transplant at age 52 died suddenly from a ruptured abdominal aortic aneurysm. All of the major epicardial coronary arteries contained considerable quantities of atherosclerotic plaque that narrowed their lumens. Their rarity in coronary arteries in contrast to their relative frequency in the aorta may in part be related to their exposure to only a systemic diastolic pressure rather than to a peak systolic pressure, as occurs in the aorta. The occurrence of aneurysm in one or more epicardial coronary arteries in donor hearts must be exceedingly uncommon. The authors have encountered coronary aneurysm in only one of 79 donor hearts studied at necropsy. They speculated that the aneurysms in both patients were examples of 'cardiac allograft vasculopathy'. These 2 patients underwent heart transplantation nearly 2 decades earlier, and few patients have computed tomography that long after a heart transplant.
