Cardiac surgery of eight children with Kawasaki disease (mucocutaneous lymph node syndrome).
The coronary arterial lesions of Kawasaki disease are characterized by multiple stenoses and aneurysms, which might lead to myocardial ischemia, myocardial infarction, mitral insufficiency due to ischemic papillary muscle dysfunction, ventricular aneurysm, etc. Eight children aged 6 to 13 years with Kawasaki disease underwent surgical treatments. These were coronary bypass surgery, coronary bypass surgery combined with right coronary aneurysmectomy and coronary bypass surgery combined with left ventricular aneurysmectomy. The postoperative course was smooth in all the patients. The selective angiography performed 1 month after the operation revealed the patency rate of 85% of the bypass grafts. However, 1 patient died suddenly during strenuous exercise 3 years after the surgery. Several points to be considered in the aortocoronary bypass in the patients with Kawasaki disease are discussed. These include the unknown fate of saphenous vein grafts and the possibility of higher incidences of graft failure in the growing children. Since the long-term postoperative results are as yet not fully understood, close follow-up of the patients treated by aortocoronary bypass surgery would be mandatory.
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D001026:Coronary Artery Bypass / Q000379:methods*; D003327:Coronary Disease / Q000601:surgery; D003331:Coronary Vessels / Q000601:surgery*; D005260:Female; D006322:Heart Aneurysm / Q000601:surgery*; D006801:Humans; D008206:Lymphatic Diseases / Q000601:surgery*; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000601:surgery*