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. 2023 Jan 28:9:101733.
doi: 10.1016/j.jaccas.2023.101733. eCollection 2023 Mar 1.

Left Main Coronary Artery Ostial Stenosis in a Pediatric Patient With Sudden Cardiac Arrest

Soham Dasgupta  1 , Joshua D Kurtz  1 , Christopher Johnsrude  1 , Edward Kim  1 , Deborah Kozik  2 , Bahaaldin Alsoufi  2
Affiliations

Left Main Coronary Artery Ostial Stenosis in a Pediatric Patient With Sudden Cardiac Arrest

Soham Dasgupta et al. JACC Case Rep. .

Abstract

Pediatric resuscitated sudden cardiac arrest may result from diverse conditions and, therefore, warrants a comprehensive work-up. Although rare, coronary artery abnormalities must be ruled out in these patients. We describe a case with congenital left main coronary artery ostial stenosis diagnosed using advanced imaging techniques. (Level of Difficulty: Advanced.).

Keywords: IVUS, intravascular ultrasound; LMCA, left main coronary artery; arrhythmia; cardiac arrest; coronary; intravascular ultrasound; pediatrics.

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Conflict of interest statement

The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
AED Defibrillation, 12-Lead ECG, and Imaging in a Pediatric Patient After Resuscitated Cardiac Arrest (A) Defibrillation with 200 J for ventricular fibrillation. (B) 12-Lead ECG demonstrating normal sinus rhythm, left ventricular hypertrophy by voltage, and diffuse ST-segment elevation. (C) Cardiac computed tomography (coronal view) demonstrating left main coronary artery ostial stenosis and acute turn of proximal LMCA (red arrow). (D and E) IVUS demonstrating dynamic LMCA ostial stenosis (diastole = light blue tracing; systole = yellow tracing). (D) IVUS imaging of the LMCA distal to the lesion. This region is widely patent with an area of 17.9 mm2. (E) IVUS image at the lesion in the LMCA during compression showing ∼60% narrowing to an area of 7.5 mm2. (F) Cardiac computed tomography (coronal view) demonstrating normal caliber of LMCA with no evidence of ostial stenosis postsurgical repair (yellow arrow). ECG = electrocardiogram; IVUS = intravascular ultrasound; LMCA = left main coronary artery.
See this image and copyright information in PMC

References

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