Coronary Ostioplasty for Congenital Atresia of the Left Main Coronary Artery Ostium in a Teenage Boy

Abstract

Atresia of the left coronary artery ostium is extremely rare. We report the case of a 13-year-old boy who played volleyball in school and collapsed with severe chest pain during practice. He was referred to our hospital, and imaging modalities showed atresia of the left main coronary artery ostium. Urgent coronary ostioplasty was performed using a patch of 0.6% glutaraldehyde-treated autologous pericardium. His postoperative course was uneventful, and he has had a normal everyday life without chest pain 8 months postoperatively. Physicians should be aware of the patient's history, as in this case, because prompt imaging diagnosis is essential when there is a high likelihood that the event is related to myocardial ischemia. Since long-term outcome is uncertain even after successful surgical revascularization, close follow-up is required.

Surgical Ostioplasty of the Left Main Coronary Artery: An Alternative to Coronary Artery Bypass Grafting in the Treatment of Left Main Stem Isolated Ostial Stenosis—A Case Series

“…In conclusion, surgical ostioplasty can be considered as an initial approach in the treatment of patients who have isolated ostial stenosis but no distal coronary disease [1]. Nonetheless, careful selection of patients, adequate intraoperative myocardial protection, proper enlargement of the ostium without distortion, and efficient postoperative care are vital in achieving good results [10,11]-such as the reduction of cardiopulmonary bypasses and the reduction of mortality and post-operatory diseases.…”