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

Introduction: 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. Materials and methods: To evaluate the etiology and clinical outcomes of CABG in this young population (10-19 years of age). Results: 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. Conclusion: 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.