Etiology and clinical outcomes in patients undergoing coronary artery bypass grafting in the second decade of life

The age of patients undergoing coronary artery bypass grafting (CABG) is progressively declining over time. Young adults are increasingly developing coronary artery disease (CAD), a condition that was once regarded as being more prevalent in the fifth or sixth decade of life.

To evaluate the etiology and clinical outcomes of CABG in this young population (10–19 years of age).

A total of five patients were included in this study. Three patients had a diagnosis of familial hypercholesterolemia, one patient had hyper-homocysteinemia, while one patient had a history of Takayasu arteritis. Eighty percent of the patients (4/5) underwent total arterial CABG, while in one patient with Takayasu arteritis, saphenous vein had to be used. The 30-day mortality was 1/5 (20%). The rest of the patients were followed up for 12 months with no major adverse cardiovascular events (MACE) after the index surgery.

The etiology of disease in young patients presenting with CAD is usually genetic, rather than environmental. This subset tends to have coronary ostial lesions, making CABG a suitable strategy owing to the presence of good distal targets. Total arterial revascularization should be the preferred strategy in these patients due to its proven long-term patency.