Expanding indications for pediatric coronary artery bypass

C. Mavroudis, C. L. Backer, A. J. Muster, E. Pahl, J. H. Sanders, V. R. Zales, M. Gevitz

Research output: Contribution to journalArticle

Abstract

Pediatric coronary artery bypass has been done mostly for ischemic complications of Kawasaki disease. We reviewed our clinical experience between 1987 and 1994 with internal thoracic artery-coronary artery bypass in one infant and five children for varying indications. Indications for coronary bypass included Kawasaki disease (2), congenital left main coronary ostial stenosis, iatrogenic coronary cameral fistula, anomalous origin of the left coronary artery from the pulmonary artery, and single coronary artery traversing between the great arteries in a patient after cardiac transplantation. An additional cohort of 34 control patients of various ages and weights (1 day to 16.1 years, 2.6 kg to 62 kg) had angiographic measurements of the right coronary, left coronary, and left internal thoracic arteries with respect to the feasibility of performing coronary artery bypass. All six patients survived internal thoracic artery-left anterior descending coronary artery bypass without evidence of perioperative myocardial infarction. Postoperative angiographic studies in five and color Doppler echocardiography in one showed graft patency. Retrospective angiographic measurements in the 34 control patients showed that internal thoracic and coronary arteries are proportionately quite large in neonates and infants compared with those in older children and adolescents. Internal thoracic artery-coronary artery bypass should be considered for the expanding indications presented herein and when emergency intraoperative life- threatening situations present themselves. Long-term patency and reoperation rates have yet to be determined.

Original languageEnglish (US)
Pages (from-to)181-189
Number of pages9
JournalJournal of Thoracic and Cardiovascular Surgery
Volume111
Issue number1
DOIs
StatePublished - Jan 1 1996
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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    Mavroudis, C., Backer, C. L., Muster, A. J., Pahl, E., Sanders, J. H., Zales, V. R., & Gevitz, M. (1996). Expanding indications for pediatric coronary artery bypass. Journal of Thoracic and Cardiovascular Surgery, 111(1), 181-189. https://doi.org/10.1016/S0022-5223(96)70415-4