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Stent implantation of left main coronary artery stenosis in an infant: Effective long-term treatment?
Coronary artery stenosis is a rare phenomenon in children. Coronary stent implantation is generally not considered a standard treatment option due to technical difficulties and potential complications in this group of patients. Nevertheless, several pediatric cases reporting successful implantation...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2015
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4453186/ https://www.ncbi.nlm.nih.gov/pubmed/26085769 http://dx.doi.org/10.4103/0974-2069.157035 |
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author | Paech, Christian Dähnert, Ingo Riede, Frank Thomas |
author_facet | Paech, Christian Dähnert, Ingo Riede, Frank Thomas |
author_sort | Paech, Christian |
collection | PubMed |
description | Coronary artery stenosis is a rare phenomenon in children. Coronary stent implantation is generally not considered a standard treatment option due to technical difficulties and potential complications in this group of patients. Nevertheless, several pediatric cases reporting successful implantation with acceptable short-term experiences have been described. The following case presents a successful stent implantation for left main coronary artery (LMCA) stenosis early after surgery for anomalous left coronary artery from pulmonary artery (ALCAPA) at the age of 6 months. The excellent mid-term results and notably the procedure's potential as a longterm treatment in small children are highlighted. A 6-month-old infant underwent surgery for ALCAPA. Due to sudden postoperative deterioration, cardiac catheterization was performed. Coronary angiography revealed severe (90%) ostial LMCA stenosis. A PROMUS drug-eluting stent (Promus Element AL3.0 × 8 mm, Boston Scientific, Natick, Massachusetts, USA) was implanted. The procedure was performed without complications. Antiplatelet therapy with acetylsalicylic acid and clopidogrel was initiated. Subsequently, cardiac function improved slowly. Cardiac catheterization 3 years 8 months after stent implantation showed no restenosis with a proximal LMCA diameter still at the 50(th) percentile for age. Neither were signs of heart failure reported at the last follow-up at 7 years of age. Presupposing normal growth, the implanted stent would thus provide sufficient myocardial perfusion with a LMCA lumen at the 40(th) percentile at the age of 16 years. In selected cases, coronary stent implantation may be an effective mid- to long-term treatment of coronary artery stenosis even in very young children. |
format | Online Article Text |
id | pubmed-4453186 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-44531862015-06-17 Stent implantation of left main coronary artery stenosis in an infant: Effective long-term treatment? Paech, Christian Dähnert, Ingo Riede, Frank Thomas Ann Pediatr Cardiol Case Report Coronary artery stenosis is a rare phenomenon in children. Coronary stent implantation is generally not considered a standard treatment option due to technical difficulties and potential complications in this group of patients. Nevertheless, several pediatric cases reporting successful implantation with acceptable short-term experiences have been described. The following case presents a successful stent implantation for left main coronary artery (LMCA) stenosis early after surgery for anomalous left coronary artery from pulmonary artery (ALCAPA) at the age of 6 months. The excellent mid-term results and notably the procedure's potential as a longterm treatment in small children are highlighted. A 6-month-old infant underwent surgery for ALCAPA. Due to sudden postoperative deterioration, cardiac catheterization was performed. Coronary angiography revealed severe (90%) ostial LMCA stenosis. A PROMUS drug-eluting stent (Promus Element AL3.0 × 8 mm, Boston Scientific, Natick, Massachusetts, USA) was implanted. The procedure was performed without complications. Antiplatelet therapy with acetylsalicylic acid and clopidogrel was initiated. Subsequently, cardiac function improved slowly. Cardiac catheterization 3 years 8 months after stent implantation showed no restenosis with a proximal LMCA diameter still at the 50(th) percentile for age. Neither were signs of heart failure reported at the last follow-up at 7 years of age. Presupposing normal growth, the implanted stent would thus provide sufficient myocardial perfusion with a LMCA lumen at the 40(th) percentile at the age of 16 years. In selected cases, coronary stent implantation may be an effective mid- to long-term treatment of coronary artery stenosis even in very young children. Medknow Publications & Media Pvt Ltd 2015 /pmc/articles/PMC4453186/ /pubmed/26085769 http://dx.doi.org/10.4103/0974-2069.157035 Text en Copyright: © Annals of Pediatric Cardiology http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Paech, Christian Dähnert, Ingo Riede, Frank Thomas Stent implantation of left main coronary artery stenosis in an infant: Effective long-term treatment? |
title | Stent implantation of left main coronary artery stenosis in an infant: Effective long-term treatment? |
title_full | Stent implantation of left main coronary artery stenosis in an infant: Effective long-term treatment? |
title_fullStr | Stent implantation of left main coronary artery stenosis in an infant: Effective long-term treatment? |
title_full_unstemmed | Stent implantation of left main coronary artery stenosis in an infant: Effective long-term treatment? |
title_short | Stent implantation of left main coronary artery stenosis in an infant: Effective long-term treatment? |
title_sort | stent implantation of left main coronary artery stenosis in an infant: effective long-term treatment? |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4453186/ https://www.ncbi.nlm.nih.gov/pubmed/26085769 http://dx.doi.org/10.4103/0974-2069.157035 |
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