Symptomatic Coronary Obstruction Due to Kawasaki Disease in an Adult

Codispoti, Cindy; Boyd, Sheri; Sees, David W.; Conner, William C.

doi:10.1016/j.athoracsur.2007.08.032

Cited by 4 publications

(4 citation statements)

References 7 publications

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“…Echocardiography was a diagnostic tool in 33 patients: coronary artery aneurysm in 17 (51.5%), regional wall abnormality (hypokinesis, or akinesis) in four (12.1%), coronary artery dilation in two (6.1%), coronary artery calcification in two (6.1%), left ventricular aneurysm in one (3.0%), intra-coronary aneurysm thrombus in two (6.1%), left ventricular dysfunction+global hypokinesis+left ventricular aneurysm+coronary artery aneurysm in one (3.0%), and normal in three (9.1%) patients, respectively. Perfusion scintigraphy was used in at least three patients for the assessment of the left ventricular function of the patients (36, 48, 55). …”

Section: Resultsmentioning

confidence: 99%

“…In 58 (9.1%) patients, concurrent aneurysm and stenosis lesions developed in 86 coronary arteries including 46 (53.5%) LADs, 28 (32.6%) RCAs, 8 (9.3%) LMs, and 4 (4.7%) circumflex coronary arteries. Other findings included coronary artery ectasia in five (16.7%) (21, 47, 55, 56), thrombosed coronary aneurysms in nine (30%), calcified coronary aneurysms in 14 (46.7%), proximal RCA dissection in one (3.3%) (70), and left ventricular aneurysm in one (3.3%) patient (28), respectively.…”

Section: Resultsmentioning

confidence: 99%

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Cardiac surgical procedures for the coronary sequelae of Kawasaki disease

Yuan

2012

Libyan Journal of Medicine

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ObjectivesThe aim of this article is to make an evaluation on the clinical features of patients with Kawasaki disease who require a cardiac surgical procedure including coronary artery bypass grafting, coronary arterial aneurysmorrhaphy or heart transplantation.MethodsEnglish literature of Kawasaki disease for cardiac surgery (1990–2011) was retrieved in the Pubmed database. The clinical features of the patient setting from the representative articles were collected and analyzed.ResultsPatients with Kawasaki disease were very young, with some requiring a cardiac surgical procedure at a very early age. The interval between the onset and the surgical operation was 9.5±9.4 years. The prevalence of myocardial infarction and re-infarction was high. Giant aneurysm, critical stenosis with calcification and thrombus formation of the coronary arteries often warrant coronary artery bypass, heart transplantation or coronary arterial aneurysm plication. The left internal mammary artery to the left anterior descending coronary artery was the most commonly used graft in coronary artery bypass. Graft patency rate was 82.4% at 21.4±32.3 (range 0.1–252) month follow-up. The early and late mortalities of this patient setting were 0.6 and 3.0%, respectively.ConclusionsPatients with Kawasaki disease may develop coronary artery lesions prone to aneurysmal formation with calcification and thrombus and may require coronary artery bypass at a very early age. With the left internal mammary artery as the first choice of bypass graft, the long-term patency and patient survival was satisfactory.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Cardiac surgical procedures for the coronary sequelae of Kawasaki disease

Yuan

2012

Libyan Journal of Medicine

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“…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.…”

Section: Discussionmentioning

confidence: 99%

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

Oleszczak-Kostyra¹,

Mazur-Jax²,

Dąbrowski³

2019

Med Case Rep Rev

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Kawasaki disease (KD) is a rare and self-limiting inflammatory disease of medium size blood vessels (mostly of coronary arteries) of unknown etiology. It develops mostly in infants and young children. Its diagnosis is based on typical clinical signs, including: fever, rash, cervical lymphadenopathy, erythema on hands and feet. The inflammatory process may lead to development of aneurysms of coronary arteries and to early atherosclerosis, resulting in acute coronary syndromes in adult patients. We present the case of a 40-years-old male probably post KD in childhood, admitted because of myocardial infarction with ST elevation (STEMI) of the anterior wall, in whom coronarography demonstrated obstruction of LAD and aneurysm of its proximal section. After an unsuccessful angioplasty the patient was qualified for coronary-aortic bypass grafting (CABG) of obstructed LAD, using the MITCAB method. Acute coronary syndromes in patients with history of Kawasaki disease during childhood are described in case reports only, and absence of any clear guidelines makes the analysis of individual cases highly valuable.

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“…Furthermore most of the patients had reached adulthood when the second intervention was required. Re-operation utilizing either the radial artery, GEA or both, and PCI using coronary stents could be applied more safely and effectively than in children ( 37 , 38 ).…”

Section: Event Incidence Following Pediatric Bypass Operation For mentioning

confidence: 99%

Pediatric Coronary Artery Revascularization Surgery: Development and Effects on Survival, Cardiac Events and Graft Patency for Children With Kawasaki Disease Coronary Involvements

Kitamura

2016

Iran J Pediatr

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Pediatric coronary artery bypass surgery gained wide acceptance with the introduction of internal thoracic arteries (ITAs) for bypass operations for post Kawasaki disease (KD) lesions. The technique is now established as the standard surgical choice, and its safety even in infancy, graft patency, growth potential, graft longevity and clinical efficacy have been well documented. In this article the author reviews the development of pediatric coronary bypass as the main indication for the treatment of coronary lesions due to KD. I believe that coronary revascularization surgery in pediatric population utilizing uni- or bilateral ITAs is the current gold-standard as the most reliable treatment, although percutaneous coronary intervention with or without a stent has been tried with vague long-term results in children.

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Symptomatic Coronary Obstruction Due to Kawasaki Disease in an Adult

Cited by 4 publications

References 7 publications

Cardiac surgical procedures for the coronary sequelae of Kawasaki disease

Cardiac surgical procedures for the coronary sequelae of Kawasaki disease

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

Pediatric Coronary Artery Revascularization Surgery: Development and Effects on Survival, Cardiac Events and Graft Patency for Children With Kawasaki Disease Coronary Involvements

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