title: Radiation-induced bilateral coronary ostial stenosis in a 17-year-old patient.
abstract: Mediastinal irradiation can induce coronary artery disease characterized by the localization of lesions at the proximal segment of the arteries. We report the case of a 17-year-old patient who underwent a mediastinal irradiation for pulmonary sarcoma and developed 15 years later an asymptomatic ischemic cardiopathy. Bilateral coronary ostial stenosis was discovered by a transthoracic echography and coronary angiography showed isolated bilateral ostial stenosis. Coronary bypass grafting was performed with internal thoracic arteries. We recommend testing exercise and echocardiography during follow-up of patients who have received more than 30 Gy of mediastinal radiation. Surgery is the treatment of choice in bilateral ostial stenosis using internal thoracic arteries in young patients if preoperative assessment shows patency.
authors.affiliation: Department of Cardiothoracic Surgery, Hôpital Robert Debré, Avenue du général Koenig, 51100 Reims, France. jffuzellier@chu-reims.fr
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Fuzellier
authors.forename: Pierre
authors.initials: P
authors.lastname: Mauran
authors.forename: Damien
authors.initials: D
authors.lastname: Metz
mesh_terms: D000293:Adolescent; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D023921:Coronary Stenosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D003937:Diagnosis, Differential; D006801:Humans; D008175:Lung Neoplasms / Q000628:therapy*; D008297:Male; D011832:Radiation Injuries / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D012509:Sarcoma / Q000628:therapy*