Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2014;67:950 - Vol. 67 Num.11 DOI: 10.1016/j.rec.2014.01.027

Coronary Stent Implantation in an Infant

Alberto Mendoza a,, Agustín Albarrán b, José M. Velasco a

a Instituto Pediátrico del Corazón, Hospital Universitario 12 de Octubre, Madrid, Spain
b Unidad de Hemodinámica y Cardiología Intervencionista, Hospital Universitario 12 de Octubre, Madrid, Spain

Article

A 9-month-old male infant (6.9 kg body weight) with aortic valve stenosis had been treated surgically with the Ross procedure. He underwent cardiac catheterization, which revealed severe obstruction at the origin of both pulmonary arteries (Figure 1) that resolved with implantation of Formula™ 414 in both pulmonary arteries (Figure 1); 12 hours later, the patient developed signs of ischemia in left coronary artery territory, with left ventricular dysfunction, and was placed on extracorporeal membrane oxygenation. Once he had been stabilized, coronary angiography was performed; this test revealed a critical obstruction in left main coronary artery (Figure 2) that resolved after implantation of a 2.25 mm × 12 mm Taxus Liberte™ stent into coronary artery (Figure 2). Ventricular function began to improve, and extracorporeal membrane oxygenation was discontinued 5 days later. When the child was 3 years old, follow-up coronary angiography revealed endothelial proliferation within the stent, with a considerable reduction in the lumen (Figure 2), that resolved after implantation of a 2.5 mm × 11 mm BioMatrix Flex™ stent (Figure 2).

Figure 1.

Figure 2.

Coronary stenosis following stent implantation into the pulmonary arteries is a very uncommon complication that can be avoided by performing imaging studies or coronary angiography simultaneously with intra-arterial balloon inflation prior to the intervention.

A high index of suspicion, together with stabilization under extracorporeal membrane oxygenation and intracoronary stent implantation, can save the patient's life.

Corresponding author: alberto.mendoza@salud.madrid.org

1885-5857/© 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

Cookies
x
To improve our services and products, we use cookies (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.
Cookies policy
x
To improve our services and products, we use cookies (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.