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Aortic valve replacement for aortic regurgitation due to Kawasaki disease. Report of two cases
S Fukunaga1, A Egashira, K Arinaga
1Second Department of Surgery, Kurume University School of Medicine, Japan.
Insights
Severe aortic regurgitation is a rare complication of Kawasaki disease (KD). Careful monitoring of aortic valve function is crucial in patients with a history of KD to detect early signs of this condition.
Area of Science:
- Cardiology
- Pediatrics
- Rheumatology
Background:
- Kawasaki disease (KD) is an acute febrile illness affecting young children.
- Cardiac complications, including valvular issues, can arise from KD.
- Long-term sequelae of KD require ongoing cardiovascular surveillance.
Observation:
- Two pediatric cases presented with severe aortic regurgitation secondary to prior Kawasaki disease.
- Echocardiography revealed aortic cusp thickening and Doppler confirmed severe regurgitation.
- Aortic valve replacement was necessary for both patients due to progressive regurgitation.
Findings:
- Histological examination of aortic valve cusps showed evidence of valvulitis.
- The onset of aortic regurgitation varied, detected within days to months after KD diagnosis.
- Progressive aortic regurgitation necessitated surgical intervention in both cases.
Implications:
- This highlights aortic regurgitation as a potential long-term complication of Kawasaki disease.
- Emphasizes the need for vigilant echocardiographic monitoring of aortic valve function in KD survivors.
- Early detection and management are key to preventing severe cardiac dysfunction in affected children.
Abstract:
Two cases of severe aortic regurgitation due to Kawasaki disease are reported. Both patients were diagnosed as having Kawasaki disease in their infancy, and were followed up by a pediatrician. Aortic regurgitation was detected 18 months in one case and 36 days in the other case after onset of the illness. With the passage of time, the aortic regurgitation increased and aortic valve replacement was scheduled in both patient at the age of 13. On admission, two-dimensional echocardiography showed thickening of the aortic cusps, and severe aortic regurgitation was detected by color flow Doppler studies. Successful aortic valve replacement was performed, and histological studies of the cusps showed sequelae of valvulitis. In conclusion, aortic regurgitation is a rare complication of Kawasaki disease, and the aortic valve function, especially occurrence of aortic regurgitation, should be carefully observed in patients with a past history of Kawasaki disease.