Complete myocardial revascularization using only pedicled arterial conduits in Kawasaki disease.
A 16-year-old boy with Kawasaki disease suffered from progressive angina and exercise intolerance for 1 year. Coronary angiography showed 60% stenosis of the left main coronary artery, a calcified aneurysm with total occlusion at the proximal left anterior descending artery (LAD), and another aneurysm with total occlusion at the middle portion of the right coronary artery. Aortocoronary bypass was done with the left internal mammary artery (IMA) anastomosed to the first obtuse marginal branch, the right IMA to the distal LAD, and the right gastroepiploic artery to the posterior descending artery. Graft patency was documented by follow-up coronary angiography 1 month after surgery. During follow-up, his rapid improvement led to an upgrade from New York Heart Association functional class III to class I. The results of the present case suggest that complete myocardial revascularization using arterial conduits in patients with Kawasaki disease with coronary artery occlusion is safe and effective.
Department of Surgery, Mackay Memorial Hospital, Taipei, Taiwan.
J Y
JY
Li
M R
MR
Chen
D000293:Adolescent; D006801:Humans; D008297:Male; D008323:Mammary Arteries / Q000601:surgery; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications*; D009204:Myocardial Revascularization / Q000379:methods*