Pediatric Applications of Surgical Patch Angioplasty of the Main Coronary Trunks

Sepehripour, Amir H.; Harling, Leanne; Ashrafian, Hutan; Athanasiou, Thanos

doi:10.1177/2150135113508795

Cited by 4 publications

(3 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These patients could have benefited from a more aggressive primary ostioplasty strategy. On the other hand, ostioplasty itself, particularly in infants with small vessel diameters, carries its own inherent risk [ 20 ]. In our experience, 1 patient (11.1% among the patients who underwent ostioplasty) developed severe stenosis at the end of the ostioplasty patch, requiring CA bypass grafting.…”

Section: Discussionmentioning

confidence: 99%

Coronary artery lesions are associated with adverse cardiac events in children undergoing supravalvular aortic stenosis repair

Luo,

Haller,

Nield

et al. 2024

Interdisciplinary CardioVascular and Thoracic Surgery

View full text Add to dashboard Cite

OBJECTIVES To identify the prevalence and anatomic characteristics of coronary artery lesions and their associated postoperative risk in patients undergoing supravalvular aortic stenosis repair. METHODS The association between structural risk factors, postoperative ST-segment changes, and major adverse cardiac events were explored using logistic regression and the Fisher’s exact test. RESULTS In 51 consecutive supravalvular aortic stenosis patients between 2000 and 2017, a total of 48 coronary lesions were identified in 27 patients(53%). Prominent ostial ridge(Type I) was the most common coronary lesion, followed by small ostium with(IIIb) or without(IIIa) diffuse long segment coronary narrowing, and adhesion of the coronary cusp(TypeⅡ). There were 54 concomitant coronary procedures, including 43 primary corrections and 11 revisions. Thirty-three patients underwent supravalvular aortic stenosis repair with a bifurcated patch; 13(39.4%) had right coronary artery distortion/kinking requiring patch plication(n = 8) and reimplantation(n = 5). Postoperative MACE occurred in nine patients(17.6%), including three deaths, four needing mechanical circulatory support, and six ventricular arrhythmias. Twenty-two patients(43.1%) had postoperative ST-segment changes, including 13 early changes that resolved within 24 hours, and 9 persistent changes lasting more than 24 hours. Patients with Type III lesions were associated with postoperative persistent ST-segment change(p = 0.04) and independently predicted postoperative MACE(p = 0.02). Patients with pre-existing coronary lesions were at elevated risk of right coronary artery distortion/kinking(p = 0.045). CONCLUSIONS The prevalence of ST-segment changes and MACE is high in patients undergoing supravalvular aortic stenosis repair. Preoperative presence of complex coronary lesions is the most important predictors for postoperative major adverse cardiac events.

show abstract

Section: Discussionmentioning

confidence: 99%

Coronary artery lesions are associated with adverse cardiac events in children undergoing supravalvular aortic stenosis repair

Luo,

Haller,

Nield

et al. 2024

Interdisciplinary CardioVascular and Thoracic Surgery

View full text Add to dashboard Cite

show abstract

“…It has been used in cases of LMCA atresia, occlusion, and inf lammatory arteritis. [14] However, there are few studies on proximal coronary artery patch-plasty. Prêtre and Turina [15] reported successful results in patients with LMCA osteal stenosis after surgical angioplasty.…”

Section: Discussionmentioning

confidence: 99%

Left main coronary artery osteoplasty with pulmonary autograft in a child with familial hypercholesterolemia

Recep¹

2022

Cardiovasc Surg Int

View full text Add to dashboard Cite

Familial hypercholesterolemia is a disease characterized by mutations in the low-density lipoprotein receptor. Total cholesterol levels >500 mg/dL and low-density lipoprotein levels >350 mg/dL are associated with early atherosclerosis. In these patients, the incidence of coronary artery disease is high in the first decade of life, and it often emerges in adolescence. Herein, we present a 14-year-old female with familial hypercholesterolemia who underwent left main coronary artery osteoplasty with a pulmonary autograft due to an incidentally detected osteal stenosis of the left main coronary artery. The patient was discharged without any problems, and no problems were detected during the follow-up.

show abstract

“…The use of surgical patch angioplasty has been described by other groups in the treatment of ostial stenosis. 12 This technique has been demonstrated to be a reliable method of repairing proximal lesions in a number of different pathologic processes ranging from Arterial Switch Operations (ASO) to Takayasu disease with low mortality. Although the patient populations described are heterogenous and cannot be directly compared to our patient, the overall results suggest the flow patterns achieved from patch angioplasty of ostial are safe in meeting myocardial demand in patients with congenital cardiac.…”

Section: Commentmentioning

confidence: 99%

Autologous Patch Angioplasty of a Giant Right Coronary Artery Aneurysm and Coronary Stenosis in Kawasaki Disease

Ganta

Kavarana

2019

World J Pediatr Congenit Heart Surg

View full text Add to dashboard Cite

We describe our management of a 2-year-old patient with Kawasaki disease with a giant proximal right coronary artery (RCA) aneurysm and a >99% RCA ostial stenosis. After median sternotomy and cardioplegic arrest of the heart, we opened the aorta and cut into the RCA ostium past the stenosis and giant aneurysm. The RCA was reconstructed with an autologous pericardial patch. Cross-clamp and cardiopulmonary bypass times of 84 minutes and 114 minutes, respectively, were required. Our approach avoids mammary harvesting and grafting in such small patients while successfully treating ischemia and hopefully prevents further aneurysmal dilation over time.

show abstract

Pediatric Applications of Surgical Patch Angioplasty of the Main Coronary Trunks

Abstract: Current evidence suggests that SPA shows encouraging outcomes in a pediatric population and, with increasing experience, may provide a definitive solution to coronary artery occlusion.

Cited by 4 publications

References 29 publications

Coronary artery lesions are associated with adverse cardiac events in children undergoing supravalvular aortic stenosis repair

Coronary artery lesions are associated with adverse cardiac events in children undergoing supravalvular aortic stenosis repair

Left main coronary artery osteoplasty with pulmonary autograft in a child with familial hypercholesterolemia

Autologous Patch Angioplasty of a Giant Right Coronary Artery Aneurysm and Coronary Stenosis in Kawasaki Disease

Contact Info

Product

Resources

About