Early and late postoperative studies in coronary arterial lesions resulting from Kawasaki’s disease in children

Suma, K; Takeuchi, Yasuo; Shiroma, K; Tsuji, Takayuki; Inoue, Kenji; Yoshikawa, Toru; Koyama, Yuji; Narumi, J; Asai, Toshio; Kusakawa, Sanji

doi:10.1016/s0022-5223(19)39037-3

Cited by 29 publications

(6 citation statements)

References 10 publications

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“…Another concern is the long‐standing patency rate of the graft. The patency rate is significantly higher for arterial grafts than for venous grafts even in children younger than 3 years old . The IMA also retains its natural curvature from the time of operation and is not stretched excessively by the patient's somatic growth .…”

Section: Discussionmentioning

confidence: 99%

Coronary artery bypass grafting in children

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Coronary artery bypass grafting in children

et al. 2018

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“…Because patients with KD are often small children or very young adults, the ideal conduit must have a patency that would last for their lifetime. Although a SVG was exclusively used as the conduit during the early development stage of PCABS for KD coronary lesions both in Japan 18 , 21 , 22 ) and in the U.S.A., 23 ) long-term patency of SVGs proved unsatisfactory, particularly in small children. As a result, a better graft material was sought.…”

Section: Surgery and Graft Selection In Pcabsmentioning

confidence: 99%

A new arena in cardiac surgery: Pediatric coronary artery bypass surgery

Kitamura

2018

Proceedings of the Japan Academy. Ser. B: Physical and Biologic

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Prior to the 1970s, pediatric coronary artery bypass surgery (PCABS) was seldomly performed due to the lack of compelling surgical indications. The advent of coronary sequelae secondary to Kawasaki disease (KD) and the occurrence of coronary artery complications due to newly developed procedures, such as the arterial switch operation and early repair for intrinsic congenital coronary malformations, necessitated the development of PCABS. Because children grow rapidly and their life expectancy is very long, with increasing exercise capability requirements, the strategy for PCABS should differ from that for bypass surgery in adults. PCABS utilizing unilateral and bilateral internal thoracic arteries (ITA) has become the most reliable surgical method for children because of the distinct structure of ITAs being resistant to KD, growth potential according to the child’s somatic growth and long-term patency without wall degeneration. This operation utilizing ITA grafts is now being performed worldwide and is referred to as the “Kitamura operation” for KD coronary sequelae. Notably, the use of vein grafts should be avoided in children. Likewise, this operation can now be successfully performed in infants using a surgical microscope, for congenital coronary disorders. Currently, PCABS with ITAs has been established as a new arena in cardiac surgery, following our initial attempts.

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“…The combined use of arterial by-pass grafting with resection of large coronary aneurysms has been reported. 3 artery, neither early nor late deaths occurred during a maximal follow-up period of 8 years. 17…”

Section: Coronary Aneurysmectomymentioning

confidence: 82%

“…An arterial aneurysm of large size but not associated with a stenotic lesion has been demonstrated hydrodynamically to produce a stenotic effect. 3 Such lesions, however, rarely cause clinically evident myocardial ischemia. As far as I know, there is, as yet, no report of rupture of an aneurysm in the longterm period of follow-up after convalescence from the disease.…”

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confidence: 99%

Surgical management for cardiovascular lesions in Kawasaki disease

Kitamura¹

1991

Cardiol Young

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SummarySummary Myocardial revascularization is now an accepted therapeutic modality for severe coronary arterial obstructive disease produced by Kawasaki disease which is amenable to usual medical treatment. The mortality rate of myocardial infarction is surprisingly high in this setting, and surgery may be able to prevent many of these deaths. This article focuses on current issues in surgical treatment of ischemic heart disease in children secondary to Kawasaki disease. Coronary arterial obstructive disease is, apparently, a leading problem followed by valvar and myocardial involvements. Introduction of bypass grafting using the internal thoracic artery in children was a major recent advance, because this graft has an excellent capability to adapt to the increments of increased flow and growth of the patient. The saphenous vein is less satisfactory when used as a graft in terms of its long-term patency, particularly in young children less than 8 years old. Although longer follow-up is certainly required, the current results of surgery have been excellent in improving myocardial perfusion, in ameliorating symptoms, and improving the quality of life.

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Early and late postoperative studies in coronary arterial lesions resulting from Kawasaki’s disease in children

Cited by 29 publications

References 10 publications

Coronary artery bypass grafting in children

Coronary artery bypass grafting in children

A new arena in cardiac surgery: Pediatric coronary artery bypass surgery

Surgical management for cardiovascular lesions in Kawasaki disease

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