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Long term follow-up after portacaval shunt and internal mammary coronary bypass graft in homozygous familial hypercholesterolemia: report of two cases.

Homozygous familial hypercholesterolemia (HFH) is characterized by a very shortened lifespan, mainly due to cardiac events, and by resistance to conventional lipid lowering therapies. Two patients are described for whom a combination of portacaval shunt and mammary coronary bypass graft were done with good long term success. A review of the actual forms of treatment of HFH is made. To the authors' knowledge, there is no report in the literature of this double surgical approach.