Percutaneous Coronary Intervention With Bioresorbable Scaffolds in a Young Child.
JAMA Cardiol
; 2(4): 430-434, 2017 04 01.
Article
in En
| MEDLINE
| ID: mdl-28030655
ABSTRACT
Importance Although much less frequent than in adults, coronary artery disease requiring revascularization may develop in children because of homozygous familial hypercholesterolemia or other underlying conditions. Percutaneous coronary intervention (PCI) with a bioresorbable scaffold (BRS) may have advantages over metallic coronary stents in this population. Objective:
To present a case of the successful treatment of unstable, multivessel coronary artery disease in a child with PCI with BRS implantation. This case highlights the limitations of conventional metal stents and the potential benefits of using BRSs in children. Design, Setting, andParticipants:
This is a case report from an academic tertiary care institution of a 3-year-old boy with homozygous familial hypercholesterolemia and unstable coronary artery disease requiring revascularization. We also briefly review the related literature. Interventions/Exposures Intravascular imaging-guided PCI of the proximal right coronary artery and the left main and proximal left circumflex arteries was performed with BRSs. Main Outcomes andMeasures:
The primary outcomes were acute procedural success and survival to liver transplant (3 months after PCI).Results:
Following BRS implantation, the patient recovered and remained free of cardiovascular symptoms 3 months after PCI. He subsequently underwent an orthotopic liver transplant for definitive treatment of homozygous familial hypercholesterolemia but died of noncardiac complications. A postmortem examination, including a histological assessment, revealed both BRSs to be patent with nonobstructive neointimal hyperplasia. Conclusions and Relevance To our knowledge, this is the first report of PCI with BRSs in a child. This represents an application of a BRS with potentially important implications for the future treatment of coronary artery disease in children and warrants further study.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Coronary Artery Disease
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Coronary Vessels
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Absorbable Implants
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Tissue Scaffolds
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Percutaneous Coronary Intervention
Type of study:
Diagnostic_studies
Limits:
Child, preschool
/
Humans
/
Male
Language:
En
Journal:
JAMA Cardiol
Year:
2017
Document type:
Article