title: Percutaneous Coronary Intervention With Bioresorbable Scaffolds in a Young Child.
abstract: Although much less frequent than in adults, coronary artery disease requiring revascularization may develop in children because of homozygous familial hypercholesterolemia or other underlying conditions. Percutaneous coronary intervention (PCI) with a bioresorbable scaffold (BRS) may have advantages over metallic coronary stents in this population.
  
  
  
  To present a case of the successful treatment of unstable, multivessel coronary artery disease in a child with PCI with BRS implantation. This case highlights the limitations of conventional metal stents and the potential benefits of using BRSs in children.
  
  
  
  This is a case report from an academic tertiary care institution of a 3-year-old boy with homozygous familial hypercholesterolemia and unstable coronary artery disease requiring revascularization. We also briefly review the related literature.
  
  
  
  Intravascular imaging-guided PCI of the proximal right coronary artery and the left main and proximal left circumflex arteries was performed with BRSs.
  
  
  
  The primary outcomes were acute procedural success and survival to liver transplant (3 months after PCI).
  
  
  
  Following BRS implantation, the patient recovered and remained free of cardiovascular symptoms 3 months after PCI. He subsequently underwent an orthotopic liver transplant for definitive treatment of homozygous familial hypercholesterolemia but died of noncardiac complications. A postmortem examination, including a histological assessment, revealed both BRSs to be patent with nonobstructive neointimal hyperplasia.
  
  
  
  To our knowledge, this is the first report of PCI with BRSs in a child. This represents an application of a BRS with potentially important implications for the future treatment of coronary artery disease in children and warrants further study.
authors.affiliation: Division of Cardiology, Columbia University Medical Center, New York, New York2Cardiovascular Research Foundation, New York, New York.
authors.forename: Tamim M
authors.initials: TM
authors.lastname: Nazif
authors.affiliation: Division of Cardiology, Columbia University Medical Center, New York, New York.
authors.forename: Sanjog
authors.initials: S
authors.lastname: Kalra
authors.affiliation: Division of Cardiology, Columbia University Medical Center, New York, New York2Cardiovascular Research Foundation, New York, New York.
authors.forename: Ziad A
authors.initials: ZA
authors.lastname: Ali
authors.affiliation: Division of Cardiology, Columbia University Medical Center, New York, New York2Cardiovascular Research Foundation, New York, New York.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Karmpaliotis
authors.affiliation: Division of Pediatric Cardiology, Columbia University Medical Center, New York, New York.
authors.forename: Mariel E
authors.initials: ME
authors.lastname: Turner
authors.affiliation: Division of Pediatric Cardiology, Columbia University Medical Center, New York, New York.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Starc
authors.affiliation: Cardiovascular Research Foundation, New York, New York.
authors.forename: Yang
authors.initials: Y
authors.lastname: Cao
authors.affiliation: Department of Pathology, Columbia University Medical Center, New York, New York.
authors.forename: Charles C
authors.initials: CC
authors.lastname: Marboe
authors.affiliation: Division of Cardiology, Columbia University Medical Center, New York, New York2Cardiovascular Research Foundation, New York, New York.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Collins
authors.affiliation: Division of Cardiology, Columbia University Medical Center, New York, New York2Cardiovascular Research Foundation, New York, New York.
authors.forename: Martin B
authors.initials: MB
authors.lastname: Leon
authors.affiliation: Division of Cardiology, Columbia University Medical Center, New York, New York2Cardiovascular Research Foundation, New York, New York5Associate Editor, JAMA Cardiology.
authors.forename: Ajay J
authors.initials: AJ
authors.lastname: Kirtane
mesh_terms: D020341:Absorbable Implants; D002675:Child, Preschool; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000601:surgery*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D054457:Tissue Scaffolds; D018084:Ultrasonography, Interventional