title: [Coronary artery bypass after Kawasaki disease].
abstract: Kawasaki disease (KD) is a systemic vasculitis of unknown etiology, which is the main cause of acquired heart disease in children in developed countries. The main complications result from the development of coronary aneurysms which can lead to ischemic heart disease. We present the case of a teenage boy with a diagnosis of KD at the age of seven. He was treated with gammaglobulin and aspirin and echocardiographic evaluation in the acute phase was apparently normal. At the age of eleven, he developed chest pain and exertional dyspnea. Nuclear perfusion scans with exercise revealed hypoperfusion of the left anterior descending (LAD) and right coronary (RC) artery territories. Cardiac catheterization showed occlusion of the proximal segments of both arteries. He underwent coronary artery bypass graft surgery (internal mammary artery bypass graft to the LAD artery and saphenous vein graft to the RC artery), with a good clinical result. This case report highlights the importance of early diagnosis and treatment of KD and regular cardiological follow-up, bearing in mind the potential late complications of this pediatric disease.
authors.affiliation: Serviço de Pediatria, Hospital de Faro, EPE, Faro, Portugal. verasantosm@yahoo.com
authors.forename: Vera
authors.initials: V
authors.lastname: Santos
authors.forename: Ana Sofia
authors.initials: AS
authors.lastname: Simões
authors.forename: Ana
authors.initials: A
authors.lastname: Teixeira
authors.forename: Miguel
authors.initials: M
authors.lastname: Abecasis
authors.forename: Marília
authors.initials: M
authors.lastname: Loureiro
authors.forename: Rui
authors.initials: R
authors.lastname: Anjos
mesh_terms: D000293:Adolescent; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications*