Percutaneous coronary intervention and subsequent endovascular beta-radiation brachytherapy in a 14-year-old with repaired anomalous left coronary artery from pulmonary artery.
Anomalous origin of the left coronary artery from pulmonary artery (ALCAPA) is a rare congenital anomaly. Re-establishment of the dual coronary system is the standard treatment, although the long-term outcome after surgical repair is not well defined. We report a case in which coronary stenting was performed to treat left anterior descending artery lesions eight months after surgical repair of ALCAPA. The patient then developed rapid in-stent restenosis within three months, which was successfully treated by rotational atherectomy, balloon angioplasty, and catheter-based beta-radiation brachytherapy. Follow-up angiograms after three and six months showed no recurrent in-stent restenosis. This represents the first report of coronary stenting in the setting of ALCAPA, and the first report of catheter-based intracoronary radiation therapy in a pediatric patient.
Kwok
O H
OH
Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
Landzberg
M J
MJ
Kinlay
S
S
Marcus
K C
KC
Rogers
C
C
D000293:Adolescent; D000800:Angioplasty, Balloon; D017225:Atherectomy, Coronary; D001610:Beta Particles; D001918:Brachytherapy / Q000379:methods; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D006083:Graft Occlusion, Vascular / Q000628:therapy; D006801:Humans; D011651:Pulmonary Artery / Q000002:abnormalities* / Q000601:surgery; D015607:Stents; D018084:Ultrasonography, Interventional