Off-pump revascularization in a 2-year-old girl after neonatal arterial switch

Area of Science:

• Cardiovascular Surgery
• Pediatric Cardiology
• Congenital Heart Disease

Background:

• Arterial switch operation for transposition of the great arteries can lead to coronary lesions in 5% of children.
• Established treatments include patch arterioplasty or coronary artery bypass grafting (CABG).
• Off-pump coronary artery bypass (OPCAB) is increasingly used in adults to avoid aortic manipulation and extracorporeal circulation.

Observation:

• A symptomatic 2-year-old child with post-arterial switch coronary lesions was evaluated.
• The patient presented with symptoms requiring intervention for coronary artery issues.

Findings:

• Off-pump coronary artery bypass (OPCAB) revascularization was successfully performed in a pediatric patient.
• This represents an adaptation of an adult surgical technique for pediatric application.

Implications:

• OPCAB may offer a viable alternative for pediatric patients with coronary lesions post-arterial switch operation.
• This approach could potentially reduce complications associated with traditional CABG in children.
• Further research is warranted to establish the long-term efficacy and safety of OPCAB in pediatric populations.