title: Cardiac surgical procedures for the coronary sequelae of Kawasaki disease.
abstract: OBJECTIVE
  The aim of this article is to make an evaluation on the clinical features of patients with Kawasaki disease who require a cardiac surgical procedure including coronary artery bypass grafting, coronary arterial aneurysmorrhaphy or heart transplantation.
  
  
  METHODS
  English literature of Kawasaki disease for cardiac surgery (1990-2011) was retrieved in the Pubmed database. The clinical features of the patient setting from the representative articles were collected and analyzed.
  
  
  RESULTS
  Patients with Kawasaki disease were very young, with some requiring a cardiac surgical procedure at a very early age. The interval between the onset and the surgical operation was 9.5±9.4 years. The prevalence of myocardial infarction and re-infarction was high. Giant aneurysm, critical stenosis with calcification and thrombus formation of the coronary arteries often warrant coronary artery bypass, heart transplantation or coronary arterial aneurysm plication. The left internal mammary artery to the left anterior descending coronary artery was the most commonly used graft in coronary artery bypass. Graft patency rate was 82.4% at 21.4±32.3 (range 0.1-252) month follow-up. The early and late mortalities of this patient setting were 0.6 and 3.0%, respectively.
  
  
  CONCLUSIONS
  Patients with Kawasaki disease may develop coronary artery lesions prone to aneurysmal formation with calcification and thrombus and may require coronary artery bypass at a very early age. With the left internal mammary artery as the first choice of bypass graft, the long-term patency and patient survival was satisfactory.
authors.affiliation: Department of Cardiothoracic Surgery, The First Hospital of Putian, Teaching Hospital, Fujian Medical University, Putian, Fujian Province, People's Republic of China. shi_min_yuan@yahoo.com
authors.forename: Shi-Min
authors.initials: SM
authors.lastname: Yuan
mesh_terms: D017668:Age of Onset; D002675:Child, Preschool; D003323:Coronary Aneurysm / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D003331:Coronary Vessels / Q000601:surgery; D005260:Female; D006083:Graft Occlusion, Vascular / Q000453:epidemiology; D016027:Heart Transplantation / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000379:methods / Q000401:mortality / Q000706:statistics & numerical data; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications*; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D010043:Outcome and Process Assessment, Health Care; D015995:Prevalence; D016019:Survival Analysis; D061665:Time-to-Treatment / Q000706:statistics & numerical data; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000379:methods / Q000401:mortality