Triple Coronary Bypass in a Child with Homozygous Familial Hypercholesterolemia
DOI:
https://doi.org/10.1532/HSF98.20051142Abstract
Here we report triple coronary bypass procedure in a 12-year-old girl with familial homozygous hypercholesterolemia and extensive coronary atherosclerosis. She had successful cardiopulmonary resuscitation at home by her father 4 months before the operation. Total cholesterol level was 1300 mg/dL initially without antilipidemic treatment. Extensive three vessel disease with right coronary proximal stenosis and left coronary ostial stenoses was determined by angiography. Left internal thoracic artery, left radial artery, and saphenous vein grafts were used for coronary revascularization. Saphenous vein graft to right posterior descending artery, radial artery graft to obtuse marginal artery, and LITA to left anterior descending artery anastomoses were performed consecutively. Ten months after the operation, she is in good condition under intensive antilipidemic therapy and weekly lipid apheresis.References
Allen JM, Thompson GR, Myant NB, Steiner R, Oakley CM. 1980. Cadiovascular complications of homozygous familial hypercholesterolemia. Br Heart J 44:361-8.nBromdan RF, Issenberg HJ, Glickstein JS, Frame R. 1996. Use of a free radial artery graft for correction of bland-white-garland syndrome. Ann Thorac Surg 62:1525-6.nErsoy U, Guvener M. 2000. Coronary revascularization in seven-years-old boy with homozygous familial hypercholesterolemia. Acta Paediatr89:1501-2.nLau GT, Lowe HC, Kritharides L. 2004. Cardiac saphenous vein bypass graft disease. Semin Vasc Med 4:153-9.nTatami R, Inoue N, Itoh H, et al. 1992. Regression of coronary atherosclerosis by combined LDL-apheresis and lipid-lowering drug therapy in patients with familial hypercholesterolemia: a multicenter study. The LARS Investigators. Atherosclerosis 95:1-13.nVerdiere C, Drobinski G, Evans JI, Cahen C, de Gennes JL, Thomas D. 1984. Right coronary ostial stenosis in homozygotyic hypercholesterolemia. Coronarographic and echocardiographic diagnosis. Presse Med 13:1770-2.nNaoumova RP, Thompson GR, Soutar AK. 2004. Current management of severe homozygous hypercholesterolaemias. Curr Opin Lipidol 15:413-22.nKitamura S, Seki T, Kawachi K, et al. 1988. Excellent patency and growth potential of internal mammary artery grafts in pediatric coronary artery bypass surgery. New evidence for a "live" conduit. Circulation 78(3 Pt 2):I129-39.nEl-Khouri HM, Danilowicz DA, Slovis AJ, Colvin SB, Artman M. 1998. Saphenous vein graft growth 13 years after coronary bypass in a child with Kawasaki disease. Ann Thorac Surg 65:1127-30.nKawasuji M, Sakakibara N, Fujii S, Yasuda T, Watanabe Y. 2000. Coronary artery bypass surgery with arterial grafts in familial hypercholesterolemia. J Thorac Cardiovasc Surg 119:1008-13.nMarais AD, Firth JC, Blom DJ. 2004. Homozygous familial hypercholesterolemia and its management. Semin Vasc Med 4:43-50. Mavroudis C, Backer CL, Duffy CE, Pahl E, Wax DF. 1999. Pediatric coronary artery bypass for Kawasaki congenital, post arterial switch, and iatrogenic lesions. Ann Thorac Surg 68:506-12.n
