Coronary artery bypass grafting in pediatric patients

Pediatric coronary artery bypass grafting (PCABG) together with other coronary artery (OCAP) procedures has been rarely employed to treat congenital and iatrogenic CA problems. We sought to evaluate hospital and follow-up outcome of patients requiring myocardial revascularization in the pediatric age. From 1969 to 2011, 66 patients from 13 ECHSA centres underwent 71 PCABGs. Median age at the time of OCAP was 2.4 years (range 2 days–18 years). Graft material included: left internal mammary artery (n=50), right internal mammary artery (n=12) and saphenous vein (n=9). 11 patients (16%) died in hospital. 15 patients required a postoperative mechanical circulatory support. Median follow-up time was 9.5 years (range 0.9–23 years). Four patients died late after a median time of 2,5 years (range 9 months - 8,8 years) from PCABG procedure. Forty-two of the survivors (42/51, 82,3%) underwent a control coronary angiography and patency was demonstrated in 34 of them (66%). PCABG and OCAP are suitable surgical options in a pediatic patients with impaired myocardial perfusion, following iatrogenic and/or congenital CA stenosis, which increases operative and mid-term survival.