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Paech C, Dähnert I, Riede FT. Stent implantation of left main coronary artery stenosis in an infant: Effective long-term treatment?. Ann Pediatr Cardiol. 2015;8(2):147-9doi: 10.4103/0974-2069.157035.
Paech, C., Dähnert, I., & Riede, F. T. (2015). Stent implantation of left main coronary artery stenosis in an infant: Effective long-term treatment?. Annals of pediatric cardiology, 8(2), 147-9. https://doi.org/10.4103/0974-2069.157035
Paech, Christian, et al. "Stent implantation of left main coronary artery stenosis in an infant: Effective long-term treatment?." Annals of pediatric cardiology vol. 8,2 (2015): 147-9. doi: https://doi.org/10.4103/0974-2069.157035
Paech C, Dähnert I, Riede FT. Stent implantation of left main coronary artery stenosis in an infant: Effective long-term treatment?. Ann Pediatr Cardiol. 2015 May-Aug;8(2):147-9. doi: 10.4103/0974-2069.157035. PMID: 26085769; PMCID: PMC4453186.
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Ann Pediatr Cardiol. 2015 May-Aug;8(2):147-9. doi: 10.4103/0974-2069.157035.

Stent implantation of left main coronary artery stenosis in an infant: Effective long-term treatment?.

Annals of pediatric cardiology

Christian Paech, Ingo Dähnert, Frank Thomas Riede

Affiliations

  1. Department for Pediatric Cardiology, University of Leipzig - Heart Center, Strümpellstr, Leipzig, Germany.

PMID: 26085769 PMCID: PMC4453186 DOI: 10.4103/0974-2069.157035

Abstract

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.

Keywords: ALCAPA; bland–White–Garland syndrome; infant; myocardial revascularization; stent

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