National survey of coronary artery bypass grafting for coronary stenosis caused by Kawasaki disease in Japan.
BACKGROUND
We surveyed the national experience of coronary artery bypass grafting (CABG) for coronary sequelae of Kawasaki disease (kDa) in 2002.


RESULTS
A questionnaire was returned from 323/552 (59%) institutions. Two hundred forty-four patients (188 male 56 female) since 1975 were identified. The mean number of grafts was 1.8 and the age at operation ranged from 1 to 44 years (median 11 years). The interval from the onset of kDa to operation ranged from 1 month to 42 years (median 8 years), whereas the follow-up period was from 7 days to 25 years (median 5 years). Previous myocardial infarction was found in 70 patients (28%). When the age at operation was older than 12 years, patency rates for internal thoracic artery grafts (ITA) at 1, 5, and 15 years were 95%, 91%, and 91%, respectively (n=156). When the age at operation was younger than 12 years, the corresponding values were significantly lower, with 1, 5, and 15 years being 93%, 73%, and 65%, respectively (n=146) (P<0.05). Reoperation was performed in 14 patients (6%). Death occurred in 15 patients (6%). Nine of the 14 late deaths were sudden. Six of 8 patients with a left ventricular ejection fraction (LVEF) <40% died.


CONCLUSIONS
The results of ITA in those aged 12 years or older were favorable. LVEF influenced prognosis.
Tsuda
Etsuko
E
Department of Pediatrics, National Cardiovascular Center, 5-7-1 Fujishirodai, Suita-shi, Osaka, 565-8565, Japan. etsuda@hsp.ncvc.go.jp
Kitamura
Soichiro
S
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000367:Age Factors; D015906:Angioplasty, Balloon, Coronary; D001241:Aspirin / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data*; D023903:Coronary Restenosis / Q000453:epidemiology / Q000628:therapy; D023921:Coronary Stenosis / Q000209:etiology / Q000601:surgery*; D003625:Data Collection; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D007564:Japan / Q000453:epidemiology; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications / Q000188:drug therapy / Q000601:surgery* / Q000628:therapy; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012086:Reoperation / Q000706:statistics & numerical data; D013318:Stroke Volume; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D016756:Immunoglobulins, Intravenous; D007166:Immunosuppressive Agents; D010975:Platelet Aggregation Inhibitors; D001241:Aspirin