We report a case of a 23-year-old man who was diagnosed with Kawasaki disease
that progressed to a coronary aneurysm in the left main coronary artery (LMA).
He had suffered from acute coronary syndrome and then underwent an emergent
percutaneous coronary angioplasty, in which a polyurethane-covered stent was
placed inside the aneurysm. The stent was thrombosed one year later, despite the
patient had been treated with anticoagulant and antiplatelet therapy. Emergency
percutaneous intervention was then performed. LMA was reopened and stent
malposition was observed. Therefore, urgent coronary bypass grafting was
performed in which a high degree of competitive flow was observed through the
reopened stent. LMA was ligated at the inflow of the aneurysm, resulting in an
improvement of graft flow. Left main ligature has not been previously
reported.
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