Outcome of coronary artery bypass grafting performed in young children.
OBJECTIVE
The long-term patency rate of coronary artery bypass grafting for which arterial grafts are used is known to be high in the pediatric population. However, this issue remains uncertain in children under 3 years of age. Here, we report the outcome in this specific population.


METHODS
From July 1988 to July 2007, 18 children less than 3 years of age (age at operation, 0.1-35 months; median, 4 months) underwent 20 coronary artery bypass graft operations using an arterial graft. Indications for bypass grafting were coronary artery complications related to the arterial switch operation for transposition of the great arteries in 12 patients (coronary obstruction in 8 patients, peroperative coronary anomalies precluding coronary transfer in 4 patients), congenital anomalies of the coronary arteries in 4 patients, and Kawasaki disease in 2 patients.


RESULTS
After a mean follow-up of 55 months (range, 1-176 months; median, 41 months), patency of 19 bypass grafts was assessed. One was occluded and 2 have necessitated a percutaneous procedure. Two patients died suddenly (1 with an occluded graft and 1 with a patent graft and hypertrophic myocardiopathy) 3.5 and 4.6 months, respectively, after bypass grafting.


CONCLUSIONS
Coronary artery bypass grafting should be considered as a possible alternative for coronary revascularization in young children. Although our series shows quite a good patency rate, this procedure remains a technical challenge and requires careful follow-up.
Legendre
Antoine
A
Pediatric Cardiology Unit, Hopital Clocheville, CHRU et Université François Rabelais de Tours, Tours, France. antoine.legendre@nck.aphp.fr
Chantepie
Alain
A
Belli
Emre
E
Vouhé
Pascal R
PR
Neville
Paul
P
Dulac
Yves
Y
Vaksmann
Guy
G
Bonnet
Damien
D
Serraf
Alain
A
D002675:Child, Preschool; D001026:Coronary Artery Bypass; D003330:Coronary Vessel Anomalies / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000601:surgery; D012189:Retrospective Studies; D014188:Transposition of Great Vessels / Q000601:surgery; D016896:Treatment Outcome; D014654:Vascular Patency