Cardiac surgical procedures for the coronary sequelae of Kawasaki disease

Area of Science:

• Cardiology
• Pediatric Cardiology
• Cardiovascular Surgery

Background:

• Kawasaki disease (KD) is a leading cause of acquired heart disease in children.
• KD can result in significant coronary artery abnormalities, including aneurysms, stenosis, and thrombosis.
• These complications may necessitate complex cardiac surgical interventions.

Purpose of the Study:

• To evaluate the clinical characteristics of patients with Kawasaki disease who underwent cardiac surgery.
• To analyze surgical outcomes, including graft patency and mortality rates.

Main Methods:

• A literature review of English-language articles published between 1990 and 2011 was conducted using the PubMed database.
• Clinical data from patients with Kawasaki disease requiring cardiac surgery were collected and analyzed.

Main Results:

• Patients undergoing surgery for KD were notably young, with a mean interval of 9.5 years from disease onset to operation.
• High prevalence of myocardial infarction and re-infarction was observed.
• Coronary artery bypass grafting (CABG) was frequently performed for giant aneurysms, stenosis with calcification, and thrombus formation.
• The left internal mammary artery (LIMA) was the preferred graft for CABG, demonstrating an 82.4% patency rate at follow-up.
• Early and late mortality rates were low at 0.6% and 3.0%, respectively.

Conclusions:

• Kawasaki disease frequently leads to coronary artery lesions requiring surgical intervention at a young age.
• CABG, particularly with LIMA, offers satisfactory long-term graft patency and patient survival in this population.
• Early recognition and management of KD-related cardiac complications are crucial.