Triple Vessel Coronary Artery Bypass Grafting in a 14-year-old Child with Familial Hypercholesterolemia-A Rare Case Report

Abstract

Familial hypercholesterolemia is a genetic disorder caused by a mutation in the low density lipoprotein (LDL) receptor gene. The homozygous type of the disease is rare and causes tendon xanthomas and coronary artery disease during the early years of life. Premature coronary artery occlusive disease in familial homozygous hypercholesterolemia might necessitate coronary bypass surgery in children and young adults We present the case of a 14-year-old boy with familial hypercholesterolemia and coronary artery disease. He underwent triple-vessel coronary artery bypass grafting with bilateral pedicled internal mammary artery and saphenous vein grafting without adverse events. Pediatric patients with familial hypercholesterolemia may present with premature coronary atherosclerosis requiring coronary artery bypass grafting. In situ internal mammary artery grafts should be the graft of choice. To the best of our knowledge, he is one of the youngest such patients reported in the English-language literature who underwent coronary artery bypass surgery.

Heterozygous Familial Hypercholesterolemia With APOE Haplotype: A Prospective Harbinger of a Catastrophic Cardiovascular Event

“…CABG in young FH patient is challenging and very seldom in the first and second decade though feasible and has good outcomes. Two cases have been reported of a 13- and a 14-year-old boy with FH who underwent triple-vessel CABG utilizing bilateral internal thoracic artery and saphenous vein grafting devoid of unfavorable events [ 20 , 21 ]. The role of CABG in FH patients with documented CAD has been elucidated in literature.…”