OCT: A Modality for Identifying Stent Failure in Pediatric Patients With Angiographically Silent Coronary Arteries

Ruochen Mao; James-Yashu Coe; Kunal Minhas; Oana Florescu; Wayne Tymchak; Daryl Schantz; Ilan Buffo; Reeni Soni; Jeff Hyman; Dionysios Pepelassis

doi:10.1016/j.jaccas.2021.04.027

OCT: A Modality for Identifying Stent Failure in Pediatric Patients With Angiographically Silent Coronary Arteries

JACC Case Rep. 2021 Jun 16;3(6):849-852. doi: 10.1016/j.jaccas.2021.04.027. eCollection 2021 Jun.

Authors

Ruochen Mao¹, James-Yashu Coe², Kunal Minhas³, Oana Florescu⁴, Wayne Tymchak⁵, Daryl Schantz^{4

6}, Ilan Buffo^{4

6}, Reeni Soni^{4

6}, Jeff Hyman⁴, Dionysios Pepelassis^{4

6}

Affiliations

¹ Department of Internal Medicine, University of Manitoba, Winnipeg, Canada.
² Department of Pediatrics, University of Alberta, Edmonton, Canada.
³ Section of Cardiology, Department of Internal Medicine, University of Manitoba, Winnipeg, Canada.
⁴ Department of Pediatrics, University of Manitoba, Winnipeg, Canada.
⁵ Section of Cardiology, Department of Internal Medicine, University of Alberta, Edmonton, Canada.
⁶ Variety Children's Heart Centre, Department of Pediatrics, University of Manitoba, Winnipeg, Canada.

Abstract

We present the case of a 16-year-old patient with anomalous left coronary artery from the left pulmonary artery requiring percutaneous coronary intervention in infancy who presented with ventricular fibrillation arrest. A coronary angiogram revealed 40% narrowing of the stent relative to the remainder of the left main coronary artery. Optical coherence tomography was performed and revealed an area stenosis of 70% relative to the native left main coronary artery. The patient had outgrown the stent. (Level of Difficulty: Advanced.).

Keywords: ACE, angiotensin-converting enzyme; ALCAPA; ALCAPA, with anomalous left coronary artery from the left pulmonary artery; CMR, cardiac magnetic resonance; DES, drug-eluting stent; ECG, electrocardiogram; LMCA, left main coronary artery; LV, left ventricular; MLA, minimum lumen area; OCT; OCT, optical coherence tomography; PCI; PCI, percutaneous coronary intervention; TTE, transthoracic echocardiography; long-term survival; outgrown stent.

Publication types

Case Reports