The recent increase in incidence of Kawasaki disease with attendant coronary artery aneurysms spurred our interest in developing a technique for selective coronary arteriographic examination of infants and children. Right and left coronary artery catheters were shaped according to the aortic root diameters and ascending aorta lengths predicted from the patient's heights. Thirty-eight studies were done in 34 patients who were 7 months to 18 years of age (median 3.2 years) and no permanent sequelae resulted. Advantages of the use of selective coronary arteriography include the ability to visualize stenoses, important branches, and intercoronary anastomoses. The technique is also useful in evaluation of anomalous coronary arteries, myocardial ischemia, and coronary artery distribution before right ventricular outflow tract reconstruction. Circulation 68, No. 5, 1021No. 5, -1028No. 5, , 1983 Arteriographic examination was performed after the child's fever subsided and erythrocyte sedimentation rate returned to normal. Although coronary artery bypass surgery has been done in relatively few patients with Kawasaki disease in Japan and the United States, the potential need for such an operation does exist in the event that antithrombotic drug therapy is not initiated in a timely manner or is discontinued prematurely, resulting in myocardial ischemia or infarction. Such surgical interventions are predicated on detailed infonnation about coronary artery anatomy and flow pattern.Indications for coronary arteriography in patients with congenital heart disease. Arteriographic examination was performed in these patients (1) Right coronary artery. We used the "L" configuration with the tip bent in the direction opposite the shaft. The length of the straight segment between two bends corresponded to the length
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