Percutaneous coronary intervention with bioresorbable scaffolds in a young child

Tamim M. Nazif, Sanjog Kalra, Ziad A. Ali, Dimitrios Karmpaliotis, Mariel E. Turner, Thomas J. Starc, Yang Cao, Charles C. Marboe, Michael B. Collins, Martin B. Leon, Ajay J. Kirtane

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

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 languageEnglish
Pages (from-to)430-434
Number of pages5
JournalJAMA Cardiology
Volume2
Issue number4
DOIs
StatePublished - Apr 2017
Externally publishedYes

Fingerprint

Dive into the research topics of 'Percutaneous coronary intervention with bioresorbable scaffolds in a young child'. Together they form a unique fingerprint.

Cite this