The role of intravascular ultrasound examination for assessment of graft vasculopathy

: Long-run development of heart transplanted patients is predominantly determined by the occurrence of graft vasculopathy. Due to the commonly diffuse and concentrical appearance of plaque in the coronary vessels, the disease defies, at least in the early stage, the conventionally used angiographic diagnostic procedures with radiocontrast agents. With the possibility to differentiate not only the lumen but also structures of the vessel walls and different tissue types, intracoronary ultrasound (IVUS) of coronary vessels yields entirely new insights in the development, the course and the prognostic importance of graft vasculopathy. Besides the extended scientific application in order to investigate the pathophysiology of graft vasculopathy and the assessment of therapeutic strategies, regular follow-ups with IVUS are nowadays used in many centers in routine care after heart transplant.