J Korean Pediatr Soc.  2003 Mar;46(3):302-307.

Thrombolytic Therapy and Long Term Follow-up Study in a Child with Kawasaki Disease Complicated by Giant Coronary Aneurysm with Thrombosis

• Moon SJ
• Lee SY
• Na KH
• Park SY
• Kim EY
• Kim KS
• Kim YW

Abstract

The long-term clinical issues in Kawasaki disease are concerned with the coronary artery lesions that result in aneurysmal formation, thrombotic occlusion, progression to ischemic heart disease, and premature atherosclerosis. We here report a 3 month old infant with Kawasaki disease complicated by giant coronary aneurysm with thrombosis. After urokinase(10,000 IU/kg) and heparin(400 IU/kg) were injected for two days as thrombolytic agents, thrombi were successfully dissolved. Even though long-term oral anticoagulation with low-dose aspirin, dipyridamole and coumadin were administered, thrombosis of the left main coronary artery was slowly increased. five years later, coronary angiography showed nearly total occlusion of the left anterior descending artery and collaterals from the right posterior branch and radionuclide scan demonstrated complete reversible perfusion defect of several portions of the left ventricle.

Keyword

Kawasaki disease; Thrombosis; Giant aneurysms; Thrombolytic agents; Coronary arteries; Occlusion

MeSH Terms

Aneurysm
Arteries
Aspirin
Atherosclerosis
Child*
Coronary Aneurysm*
Coronary Angiography
Coronary Vessels
Dipyridamole
Fibrinolytic Agents
Follow-Up Studies*
Heart Ventricles
Humans
Infant
Mucocutaneous Lymph Node Syndrome*
Myocardial Ischemia
Perfusion
Thrombolytic Therapy*
Thrombosis*
Warfarin
Aspirin
Dipyridamole
Fibrinolytic Agents
Warfarin