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[Giant Aneurisms of Coronary Arteries in the Kawasaki Syndrome]
G A Lyskina1,2, O L Bokeriya1,2, O G Shirinskaya1,2
1I.M. Sechenov First Moscow State Medical University, Moscow, Russia.
Insights
Kawasaki disease patients with giant coronary aneurysms face risks of thrombosis and stenosis. Long-term management and timely intervention are crucial for preventing severe complications in pediatric vasculitis.
Area of Science:
- Pediatric Cardiology
- Systemic Vasculitis Research
- Coronary Artery Disease
Background:
- Kawasaki disease is an acute childhood vasculitis potentially affecting coronary arteries.
- It can lead to acute coronary syndrome in children and young adults.
Purpose of the Study:
- To investigate clinical and demographic features of Kawasaki disease patients with giant coronary aneurysms.
- To evaluate the long-term prognosis for these patients.
Main Methods:
- Echocardiography, multispiral computed tomography, and invasive coronary angiography were used.
- 262 children diagnosed with Kawasaki disease were examined between 2003 and 2015.
Main Results:
- Coronary artery aneurysms were identified in 32.1% of patients (84/262), with 15 having giant aneurysms (>8 mm).
- Follow-up revealed intracoronary thrombi in 11 patients, leading to right coronary artery occlusion in two and stenosis requiring surgery in five.
- One patient experienced myocardial infarction prior to surgical intervention.
Conclusions:
- Patients with Kawasaki disease and giant coronary aneurysms are prone to coronary thrombosis and stenosis.
- Regular monitoring, thrombosis prevention, and prompt surgical intervention are vital for managing these high-risk patients and preventing life-threatening outcomes.
Background:
Kawasaki disease is an acute systemic vasculitis of childhood with possible coronary artery involvement which can cause acute coronary syndrome in children and young adults.
Purpose:
to study clinical and demographic characteristics of patients with Kawasaki disease with giant coronary aneurysms, to assess long-term prognosis in these patients.
Material And Methods:
In 2003-2015 262 children with Kawasaki disease were examined in the University Children Hospital of the I.M. Sechenov Moscow State Medical University. The following methods of visualization of coronary arteries were used: echocardiography in all, multispiral computer tomography in 29, invasive coronary angiography in 11 patients.
Results:
Aneurysms of coronary arteries were found in 84 patients (32.1%), in 15 of them aneurisms were giant (internal diameter >8 mm). During follow-up (from 0.67 to 12, median 5.8 years) intracoronary thrombi were found in 11 patients. Two of them had occlusions of the right coronary artery, 5 had coronary artery stenosis which required surgical intervention. One patient developed myocardial infarction before coronary surgery.
Conclusion:
Patients with Kawasaki disease with giant aneurysms of coronary arteries are predisposed to coronary thrombosis and stenosis. Long-term management of patients with regular examination, prevention of coronary thrombosis, and timely surgical intervention are necessary for lowering the risk of life-threatening complications.
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