Abstract 140: A study on 15 patients with Kawasaki disease who underwent coronary bypass surgery at our hospital

Abstract

Background: Kawasaki Disease (KD)-related coronary artery aneurysm results in stenotic lesions due to thrombus formation and intimal thickening. In its acute phase, KD may follow an acute course due to thrombotic occlusion leading to myocardial infarction. On the other hand, in the convalescent phase, it does not follow a rapid course due to the development of collateral circulation and often occurs with chest pain. In this study, we retrospectively analyzed the following variables in patients who underwent bypass surgery: clinical course until initiation of surgical treatment, indication of surgical treatment. Subjects and Methods: The subjects were 15 patients who underwent coronary artery bypass graft (CABG) surgery at our hospital (male:female ratio, 8:7; age, 24-58 years; mean age, 38.3 years). In these subjects, we examined the age at onset, period until initiation of surgical treatment, presence or absence of symptoms, radiographic findings, indications for surgical treatment, and operative methods. Results: The age at onset of KD was between 6 months and 12 years. For 3 patients, KD was not diagnosed in childhood and the diagnosis was based on calcification and chest radiography findings. The period from onset to surgical treatment ranged 7-42 years (mean, 25.6 years). Most of the subjects underwent surgical treatment during adulthood. Radiography showed bilateral lesions in 14 patients, complete occlusion of the right coronary artery in 5 patients, and calcification in 4 patients. Collateral circulation developed in all subjects who underwent surgical treatment during adulthood. Although exertional chest pain was observed in 9 patients, no patient required emergency CABG. Surgical treatment involving the bilateral inferior mesenteric arteries was performed in 14 patients. In 2 patients, a bulky mass was resected from the right coronary artery. Conclusion: The mean age at surgery was approximately 40 years. There were many subjects in whom the time elapsed since disease onset was long, which was presumably attributed to the development of collateral circulation. Therefore, it is necessary to examine such patients using diagnostic imaging or stress myocardial scintigraphy even if they are asymptomatic.