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, AND PARTICIPANTS: 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 AND MEASURES: 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.
Original language | English |
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Pages (from-to) | 430-434 |
Number of pages | 5 |
Journal | JAMA Cardiology |
Volume | 2 |
Issue number | 4 |
DOIs | |
State | Published - Apr 2017 |
Externally published | Yes |