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Published on: September 15, 2023
Off-pump coronary bypass grafting for kawasaki disease
Sudeep Verma1, Charumathi Dasarathan, R Premsekar
1Department of Pediatric Cardiology and Cardiovascular Thoracic Surgery, International Institute of Cardiovascular and Thoracic Surgery, Frontier Life Line Hospital, Dr. K. M Cherian Heart Foundation, Chennai, Tamil Nadu, India.
Insights
Kawasaki disease can lead to coronary artery blockages. Coronary artery bypass graft (CABG) surgery successfully treated a child with acute coronary artery occlusion, restoring blood flow and preventing further heart damage.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Surgery
- Rheumatology
Background:
- Kawasaki disease is a leading cause of acquired heart disease in children.
- Coronary artery aneurysms and thrombotic occlusions are serious complications.
- Early diagnosis and intervention are crucial for favorable outcomes.
Observation:
- A 6-year-old girl with known Kawasaki disease presented with acute angina and myocardial dysfunction.
- The patient had acute thrombotic occlusion of the right coronary artery (RCA).
Findings:
- The patient successfully underwent beating heart off-pump coronary artery bypass graft (CABG) surgery.
- The right internal mammary artery (RIMA) was grafted to the distal RCA.
- Follow-up computed tomography angiogram confirmed a well-flowing RIMA graft without obstruction or kinking.
Implications:
- CABG is a safe and effective life-saving procedure for pediatric patients with emergent coronary artery complications.
- Expert surgical management can achieve excellent long-term results in complex pediatric cardiovascular cases.
- This case underscores the importance of timely surgical intervention in Kawasaki disease-related coronary artery disease.
Abstract:
A 6-year-old girl, a known case of Kawasaki disease, presented with acute thrombotic occlusion of right coronary artery (RCA) with symptoms of acute angina and myocardial dysfunction. She underwent beating heart off-pump coronary artery bypass graft (CABG) surgery with right internal mammary artery (RIMA) grafted to distal RCA. Follow-up computed tomography angiogram revealed well-flowing RIMA with no obstruction or kink. This case highlights the importance of CABG as a safe and life-saving procedure in expert hands, even for children in emergent conditions.
