Coronary artery bypass grafting in children |
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| Authors: | Ahmet Arnaz MD Tayyar Sarioglu MD Yusuf Yalcinbas MD Ersin Erek MD Riza Turkoz MD Ayla Oktay MD Arda Saygili MD Dilek Altun MD Ayse Sarioglu MD |
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| Affiliation: | 1. Department of Cardiovascular Surgery, School of Medicine, Acibadem University, Istanbul, Turkey;2. Department of Cardiovascular Surgery, Acibadem Bakirkoy Hospital, Istanbul, Turkey;3. Department of Pediatric Cardiology, Acibadem Bakirkoy Hospital, Istanbul, Turkey;4. Department of Pediatric Cardiology, School of Medicine, Acibadem University, Istanbul, Turkey;5. Department of Anesthiology and Reanimation, Acibadem Bakirkoy Hospital, Istanbul, Turkey |
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| Abstract: | Background We present our clinical experience with coronary artery bypass grafting (CABG) in children. Methods Ten children who underwent CABG between July 1995 and August 2017 were retrospectively analyzed. Data including congenital cardiac malformations, previous surgical procedures, age and sex, type of coronary complications, ischemic events preceding surgery, and ventricular function before and after CABG were recorded. Results The study population consisted of five males and five females with a median age of 2.5 years (range, 88 days to 15 years). Eight internal mammary arteries (IMAs) and two saphenous veins were used for grafting. Indications for bypass grafting were coronary artery (CA) complications related to the post‐arterial switch operation in six, CA complications during the Ross procedure in two, and an iatrogenic CA injury during complete repair of tetralogy of Fallot with abnormal CA, crossing the right ventricular outflow tract in two patients. Six of the grafts were performed as rescue procedures. Three patients died during hospitalization. The mean follow‐up time was 6.8 years (range, 3 months to 18 years). Anastomoses were evaluated by coronary angiography in four patients, and were all patent. Echocardiography revealed normal myocardial function in all patients. Conclusion Our study suggests that the IMA should be the graft of choice in children due to its growth potential and long‐term patency. |
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| Keywords: | coronary complications coronary translocation pediatric coronary artery bypass rescue procedure |
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