Revascularisation of a Giant Coronary Artery Aneurysm in Suspected Incomplete Kawasaki-Disease

Abstract

Kawasaki disease leads to typical vascular complications in up to 20 % of untreated cases. We describe a 47-year-old patient with coronary vessel disease, involving the right coronary artery with a huge aneurysmatic dilatation, suspicious for an incomplete form of Kawasaki disease. We found little information about the surgical treatment and postoperative course of this disease in adults. Typically, these infrequent patients present with acute myocardial infarction and require interdisciplinary decision-making.

Severe triple vessel coronary artery disease and aneurysms in a young white man: disease progression of childhood Kawasaki disease

“…There has been a relative paucity of reports of surgical revascularization for adult survivors of childhood Kawasaki disease [1,2]. This report also emphasizes the importance of early recognition of the often missed, incomplete form of Kawasaki Disease which, when aggressively treated, may reduce the risk of future development of CAAs.…”

“…The first post-mortem report of CAA was in 1761 by Morgagni, but today they are recognized ante-mortem because of widespread coronary angiography. Atherosclerosis is the most common cause of CAA; in young adults, vasculitis (Kawasaki disease) secondary to childhood infection is increasingly recognized as a predisposing factor [1,2]. Kawasaki disease is more prevalent in Japan and children of Japanese ancestry [3].…”

Acute closure of the left anterior descending artery in a young patient with suspicion of past Kawasaki disease during childhood - A case study

“…Angioplasty of coronary arteries in a site below an aneurysm may be difficult, and often proves unsuccessful, as was in the case of the presented patient. There are no clear therapeutic guidelines for that kind of patients [6][7][8][9][10]. In face of absence of guidelines, the analysis of single cases is particularly valuable.…”

Surgical Treatment of Giant Coronary Artery Aneurysm Secondary to Kawasaki Disease

“…Therefore, coronary aneurysm is the main cause of acquired coronary artery disease in infants [lliadis 2002;Kitamura 2002;Reinerth 2006].…”