Abstract
Premature coronary artery occlusive disease in familial homozygous hypercholesterolemia might necessitate coronary bypass surgery in children and young adults. Arterial grafts have been shown to be superior to venous grafts in children, with longer patency rates and a better growth potential. Young adults with familial hypercholesterolemia also fare better with internal thoracic grafts, although the benefit of multiple arterial grafts is still unproved in this setting. Surgical angioplasty of the main coronary arteries is another alternative to preserve the precious arterial conduits for future reoperations. Saphenous venous grafts, although inferior, have also been found to have some growth potential and long-term patency, even up to 22 years. The subject of this report is a 12-year-old child with familial homozygous hypercholesterolemia and severe obstructive coronary artery disease who underwent a total arterial revascularization. To the best of our knowledge, this is the first report of total arterial revascularization at this age.
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