Extrinsic compression of the left main coronary artery in a child: Is a drug-eluting stent the best solution?

The case of a 5-year-old child with Marfan Syndrome with a left main coronary complication during elective cardiac surgery is presented (mitral valve repair for severe regurgitation and Yacoub surgery with coronary reimplantation due to dilated aortic root). Extrinsic compression of the left main occurred, leading to hemodynamic deterioration and severe left ventricular dysfunction. Emergent angioplasty balloon was performed, ultimately necessitating the implantation of a stent due to its greater radial force. The procedure was guided by intravascular ultrasound to achieve an optimal result. Numerous questions arose regarding the resolution of this case, and finding the best possible solution was crucial due to the patient's age.