Coronary artery bypass grafting for Kawasaki disease.
BACKGROUND
Kawasaki disease (KD) is the leading cause of pediatric ischemic heart disease. The incidence of serious coronary sequelae is low and about 2% - 3% of patients with KD, but once myocardial infarction occurs in children, the mortality is quite high and 22% at the first infarction.This study aimed to evaluate the efficacy of coronary artery bypass grafting (CABG) in patients with KD.


METHODS
Eight patients with a history of KD underwent CABG between October 1997 and July 2005. The number of bypass grafts placed was 2 to 4 per patient (mean 2.5 +/- 0.8). Various bypass grafts were used in patients, i.e. the left internal mammary artery (LIMA) in 3 patients, bilateral internal mammary artery (IMA) in 2 patients, LIMA plus gastroepiploic artery (GEA) in 1 patient and total saphenous vein grafts (SVGs) in 2 patients. The combined procedures included ventricular aneurysmectomy in 1 patient, mitral valve plasty in 1 and right coronary aneurysmectomy in 1. One patient was not able to wean from cardiopulmonary bypass (CPB), after being supported with intra-aortic balloon pump (IABP), the patient was weaned from CPB successfully.


RESULTS
One patient died of low cardiac output syndrome and acute renal failure 19 days after operation. Other patients recovered and were discharged uneventfully. During the follow-up that ranged from 3 to 57 months (mean 27 months), clincal angina disappeared or improved. Cardiac function was in Class I - II (NYHA).


CONCLUSIONS
CABG is a safe and effective procedure for Kawasaki coronary artery disease. However long-term results need to be followed up.
Guo
Hong-wei
HW
Department of Surgery, Fu Wai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100037, China.
Chang
Qian
Q
Xu
Jian-ping
JP
Song
Yun-hu
YH
Sun
Han-song
HS
Hu
Sheng-shou
SS
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003323:Coronary Aneurysm / Q000473:pathology / Q000601:surgery; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult