Pediatric coronary artery revascularization: a European multicenter study
Vladimiro L Vida1, Gianluca Torregrossa, Marco De Franceschi
1Pediatric and Congenital Cardiac Surgery Unit, Department of Thoracic, Cardiac and Vascular Sciences, University of Padua, Italy.
The Annals of Thoracic Surgery
|July 30, 2013
Summary
Pediatric coronary artery bypass grafting (PCABG) and other coronary artery procedures offer suitable surgical options for children with impaired myocardial perfusion. These techniques improve operative and midterm survival, necessitating lifelong patient follow-up.
Area of Science:
- Cardiology
- Pediatric Surgery
- Cardiovascular Surgery
Background:
- Surgical revascularization techniques are crucial for pediatric patients with congenital or acquired heart conditions affecting myocardial perfusion.
- Evaluating the outcomes of different surgical approaches is essential for optimizing treatment strategies in this vulnerable population.
Purpose of the Study:
- To assess the hospital and midterm results of various surgical revascularization techniques in pediatric patients.
- To compare the efficacy of pediatric coronary artery bypass grafting (PCABG) and other coronary artery procedures (OCAP) in improving survival and clinical outcomes.
Main Methods:
- A retrospective analysis of 80 pediatric patients (excluding Kawasaki disease) from 13 European centers between 1973 and 2011.
- Data included 65 PCABG and 27 OCAP procedures, with 12 patients undergoing combined procedures. Patient demographics, procedural details, and outcomes were recorded.
Main Results:
- Hospital mortality was 15% (12 patients), associated with younger age at surgery and emergent procedures.
- Midterm follow-up (median 7.6 years) revealed 3 late cardiac deaths post-PCABG.
- Symptomatic presentation (heart failure, angina) correlated with reduced ejection fraction and mitral regurgitation; reintervention was needed for stenotic or atretic grafts.
Conclusions:
- Both PCABG and OCAP are viable surgical options for pediatric patients experiencing impaired myocardial perfusion.
- These procedures enhance operative and midterm survival rates.
- Lifelong monitoring is recommended for these patients to manage potential causes of ongoing myocardial ischemia.
Keywords:
20
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