[Aorto-coronary bypass surgery for children with Kawasaki disease].
The results of aorto-coronary bypass surgery in 28 children with coronary artery lesions due to Kawasaki disease were evaluated. Ages at surgery ranged from one to 17 years, and the intervals from disease onset to surgery ranged from 2 months to 16.8 years. All patients were followed by selective coronary arteriography, thallium myocardial imaging, ECG at rest, and the Master double step and treadmill exercise tests. The surgical outcomes were analyzed by comparing the results of pre-operative examinations with those of one month, one year, and more than 3 year post-operative examinations. At one month, one year, and more than 3 year post-operative examinations, the incidences of patency of internal mammary artery graft (IMAG) were 29/30 (97%), 25/29 (86%), and 7/8 (88%), and those of patency of saphenous vein graft (SVG) were 6/7 (86%), 6/9 (67%), and 3/7 (43%), respectively. Three patients out of 4 who showed occlusion of their IMAGs within one year after surgery, and one deceased case apparently had problems related to the surgical procedures, such as the timing of surgery, reconstruction of the main trunk of coronary artery and the site of anastomoses between aneurysms. Pre-operative, one month, and one year post-operative thallium myocardial imagings were compared to examine the changes of regional myocardial ischemia in 24 children, and 28 IMAGs and 8 SVGs were evaluated. In the 28 IMAGs, 14/28 (50%) showed improvement of the myocardial ischemia, and 2/28 (7%) showed deterioration at one month follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)
Suzuki
A
A
Department of Pediatrics, National Cardiovascular Center, Suita.
Kamiya
T
T
Ono
Y
Y
Nakamura
Y
Y
Yagihara
T
T
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000209:etiology / Q000601:surgery*; D004562:Electrocardiography; D004691:Endarterectomy; D005500:Follow-Up Studies; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D007223:Infant; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications*; D011877:Radionuclide Imaging; D012501:Saphenous Vein / Q000637:transplantation; D013794:Thallium Radioisotopes; D014654:Vascular Patency
D013794:Thallium Radioisotopes