J Korean Pediatr Cardiol Soc.  2006 Dec;10(4):373-384.

Surgical Treatment for Kawasaki Disease

• Yang JH
• Jun TG
• Lee YT

Abstract

Kawasaki disease is characterized by a variety of symptoms and signs resulted from systemic vasculitis. Although the etiology of the disease remains uncertain, its serious coronary sequelae have been proved to cause ischemic heart disease in children. Coronary artery aneurysms or ectasia develop in approximately 20% of untreated children with the disease and may lead to coronary ischemia. Although the incidence of severe coronary arterial stenosis is low (2-3%), but once myocardial infarction occurs in children, the mortality is quite high (22% at the first infarction). Children with coronary aneurysms should be assessed carefully with periodic stress testing for reversible ischemia. Coronary artery bypass surgery is indicated when there is an evidence of myocardial ischemia even in small children. However, one should keep in mind that the ability to recanalize or develop collateral vessels in children is very high and recanalization is frequently noted in the right coronary artery. Internal thoracic arteries are the graft of choice. We performed coronary bypass grafting in 5 patients with Kawasaki disease since 2001. The mean age of the patients was 18.8+/-11.2 (range, 2-30) year. The mean number of anastomosis was 1.8+/-1.1. All patients survived and have revealed no evidence of myocardial ischemia during follow-up.

Keyword

Kawasaki disease; Coronary artery disease; Coronary artery bypass

MeSH Terms

Aneurysm
Child
Constriction, Pathologic
Coronary Aneurysm
Coronary Artery Bypass
Coronary Artery Disease
Coronary Vessels
Dilatation, Pathologic
Exercise Test
Follow-Up Studies
Humans
Incidence
Ischemia
Mammary Arteries
Mortality
Mucocutaneous Lymph Node Syndrome*
Myocardial Infarction
Myocardial Ischemia
Systemic Vasculitis
Transplants