Coronary angioplasty for congenital obstruction of the left main coronary artery

Abstract

We present three children who underwent coronary angioplasty for the surgical treatment of a congenital obstruction of the left main coronary artery. An azygos vein patch or graft was a feasible and useful material for reconstructing congenital ostial stenosis and atresia of the left main coronary artery.

Infantile dilated cardiomyopathy due to congenital left main coronary ostial stenosis

“…Three cases were repaired using an azygos vein graft or patch. 10 The success in our case of the pericardial patch supports the use of direct ostial repair rather than coronary artery bypass grafting.…”

Isolated Congenital Coronary Ostial Stenosis in a Young Infant: A Case Report

“…7 Surgical reconstruction of the left main coronary artery can be achieved using either autologous pericardium or saphenous vein patch; neither of them showed postoperative calcifications or aneurismal dilatation. 8,9 Pericardial patch augmentation of coronary arteries in neonates/children does carry a risk of developing stenosis in the long term: Surveillance should be done periodically with noninvasive advanced imaging. 10 In our patient, surgical revascularization was performed by using fresh autologous pericardium for coronary angioplasty.…”

Percutaneous Coronary Intervention in an 8-Month-Old Infant for Ostial Stenosis of a Reimplanted Left Main Coronary Artery

“…Percutaneous coronary intervention can be used as a minimally invasive approach to correct such complications after surgical reimplantation in ALCAPA. Despite its ubiquity in the treatment of atherosclerotic coronary artery disease in adults, PCI is performed infrequently in the pediatric population with less than 100 cases reported involving the left main coronary artery (LMCA) [ 1 ]. The small vessel size of infants in particular contribute to the complexity of PCI procedures undertaken in this age group and present a host of periprocedural complications related to catheter and stent to patient size mismatch: occlusion ischemia, vessel dissection or rupture, and creation of intimal flaps which may lead to subsequent myocardial ischemia and infarction [ 2 ].…”