Thoracoabdominal and coronary arterial aneurysms in a young man with a history of Kawasaki disease

Abstract

We report a case of a large symptomatic thoracoabdominal aortic aneurysm in a 22-year-old man with a history of Kawasaki disease in childhood. According to multislice computed tomography scan findings, the aneurysm was classified as Crawford type III. Coronary angiography revealed a giant aneurysm of the left coronary artery and aneurysm of the circumflex artery. Functional tests for myocardial perfusion and function revealed no significant ischemic territories. Because of symptoms of imminent rupture, aneurysm resection and aortic reconstruction with a 26-mm zero porosity Dacron graft was performed and was successful. Cardiovascular consequences of Kawasaki disease are discussed with attention to the late sequelae. Indications for surgical treatment and importance of follow-up into adulthood are emphasized.

Kawasaki disease: a review with emphasis on cardiovascular complications

“…2), are more frequently found in the proximal segments and at bifurcations and are often multiple (Fig. 3) [12]. The lesions in the coronary arteries seem to progress differently: the aneurysms in the right coronary artery (RCA) are more prone to massive thrombosis, whereas those in the left coronary artery (LCA) are more prone to progressive focal stenosis [13].…”

An Extremely Large Coronary Aneurysm Associated with a Quadricuspid Aortic Valve in an Adult Patient

“…Coronary artery aneurysms may be caused by coronary arteritis, congenital malformations, postcoronary interventions and chest trauma (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12). The aneurysm in the present case was associated with coronary pulmonary artery fistulas and had a short trunk measuring 2-3 mm in length branching from the left anterior descending coronary.…”

“…The etiology of coronary aneurysms involves congenital malformation, atherosclerosis, chest trauma, Kawasaki disease, sarcoidosis, Behcet's disease, systemic lupus erythematosus, directional coronary atherectomy and postimplantation of a drug-eluting stent (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12). Coronary artery fistulas are a common congenital disease that is often combined with giant coronary aneurysms (13).…”

Children with kawasaki disease present elevated stiffness of great arteries: Phase‐contrast MRI study

“…Elevated central aortic stiffness is a strong risk marker for developing systemic hypertension and overall negative cardiovascular events . Furthermore, there is a considerable amount of case reports describing development of large aneurysms in thoracic and thoraco‐abdominal aorta in acute and chronic disease phases . Clinical follow‐up may then also consider global aortic and systemic arterial evaluation in order to prevent acute aortic events.…”