Cardiac surgical procedures for the coronary sequelae of Kawasaki disease

Abstract

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.

Incomplete Kawasaki disease complicated with acute abdomen: A case report

“…The age of onset of KD is small, and cardiac surgery should be performed at an early stage. It has been reported that the average time interval between age of onset and surgical treatment is 9.5 ± 9.4 years[ 21 ]. Anastomosis of the internal mammary artery with LAD is the most common bypass graft approach for CABG.…”

Giant right coronary artery aneurysms presenting as a cardiac mass

“…Surgical intervention for giant CAA appears to be the treatment of choice in the reported literature. [ 19 ] Resection of coronary artery aneurysm with CABG is the most frequently chosen treatment modality for giant CAA. [ 20 ] Covered stents were also reported to treat giant CAA.…”

Cardiac and vascular causes of persistent fever: A systematic review

“…Approximately half of coronary artery aneurysms resolve within 1-2 years (Bartoloni et al, 2002), but stenosis of the affected vessel might develop with healing (Mueller et al, 2009). Kawasaki patients with coronary aneurysm and/or calcification/thrombus requires coronary artery bypass at a very young age (Yuan, 2012b).…”