Coronary bypass in an adult with Kawasaki disease
Moncef Bey1, Slim Chenik, Habib Thameur
1Department of Cardiovascular and Thoracic Surgery, Military Hospital of Tunis, Montfleury.
The Heart Surgery Forum
|May 13, 2004
Insights
Kawasaki disease can lead to severe coronary artery disease (CAD) even in young adults with few risk factors. This case highlights CAD secondary to Kawasaki disease, requiring bypass surgery.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Immunology
Background:
- Kawasaki disease (KD) is a leading cause of acquired heart disease in children.
- KD can lead to coronary artery aneurysms and stenosis, potentially causing atherosclerosis later in life.
- Adult-onset cardiovascular complications from childhood KD are increasingly recognized.
Observation:
- A 30-year-old female presented with symptoms suggestive of coronary artery disease.
- The patient had minimal traditional risk factors for atherosclerosis.
- Coronary angiography revealed three-vessel coronary artery disease, including a total occlusion of the left anterior descending artery and a right coronary artery aneurysm.
Findings:
- The patient's severe coronary artery disease was suspected to be a long-term sequela of Kawasaki disease.
- A quadruple coronary artery bypass graft surgery was successfully performed.
- The patient experienced an uneventful postoperative recovery.
Implications:
- This case underscores the importance of long-term cardiovascular surveillance in individuals with a history of Kawasaki disease.
- It highlights the potential for Kawasaki disease to cause premature and severe coronary artery disease in adulthood.
- Early recognition and intervention are crucial for managing complex coronary artery disease in this patient population.
Abstract:
We present the case of a 30-year-old female patient with few coronary risk factors for atherosclerosis but with 3-vessel coronary artery disease possibly secondary to Kawasaki disease. Coronary angiography showed total occlusion of the left anterior descending artery and a right coronary artery aneurysm. Quadruple coronary artery bypass was performed. The postoperative course was uneventful.
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