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Surgical experience with coronary arterial sequelae of Kawasaki disease in children
Insights
Surgical treatment for Kawasaki disease coronary artery issues in children shows good early results, with 86% graft patency after aortocoronary bypass surgery. Long-term follow-up is essential for these pediatric cardiac patients.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Surgery
- Rheumatology
Background:
- Kawasaki disease frequently causes coronary artery aneurysms in children.
- These aneurysms can lead to stenosis, thrombus, and calcification, impacting coronary blood flow.
- Surgical intervention is sometimes necessary to manage severe coronary sequelae.
Observation:
- Five children (6-9 years old) with Kawasaki disease underwent surgical treatment for coronary artery damage.
- Procedures included aortocoronary bypass surgery in all cases.
- One patient had coronary artery aneurysmectomy, and another had left ventricular aneurysmectomy.
Findings:
- Early surgical outcomes were positive, with 86% graft patency confirmed by angiography one month post-operation.
- Aortocoronary bypass surgery demonstrated good early efficacy in this pediatric cohort.
- Coronary artery damage in Kawasaki disease characteristically involves aneurysms with stenosis, irregularity, and thrombus.
Implications:
- Aortocoronary bypass surgery is a viable option for managing coronary arterial sequelae of Kawasaki disease in children.
- Long-term monitoring of autogenous saphenous vein grafts is crucial.
- Further research should focus on the durability and long-term outcomes of these surgical interventions in pediatric patients.
Abstract:
The coronary arterial sequelae due to Kawasaki disease have been treated surgically in five children ranged from 6 to 9 years old. The procedures were aortocoronary bypass surgery in all cases, coronary artery aneurysmectomy in one case and left ventricular aneurysmectomy in one case. The early results of operated cases have been good with the graft patency of 86% confirmed by angiography one month after surgery. The characteristic features of coronary artery damage in patients with Kawasaki disease are coronary artery aneurysms, which manifest wall irregularity, thrombus, calcification and stenosis. The significant stenosis of coronary artery could often be observed at the inlet or outlet of the aneurysm in major coronary artery branches. Although the early results of aortocoronary bypass surgery in the children with Kawasaki disease have been good, long-term follow up is mandatory to investigate the status of autogenous saphenous vein grafted in children.