title: [Anesthesia for coronary revascularization in patients with Kawasaki disease: case report].
abstract: Kawasaki disease is a self-limited vasculitis that occurs predominantly in infants and young children, that is characterized by coronary artery lesions (especially aneurysms). It is one of the leading causes of acquired heart disease in children. The etiology of Kawasaki disease still remains unknown. A hypothesis is that an infectious agent produces clinically apparent disease only in certain genetically predisposed individuals. It also is possible that the disease results from an immunologic response and is triggered by different microbial agents. For unknown reason it dominates in Asians. Treatment is directed to prevent coronary thrombosis and reduce inflammation; it is based on high-dose intravenous immunoglobulin and acetyl salicylic acid, which significantly reduce the risk of coronary artery aneurysms from 25 to 4%. In order to reduce myocardial ischemia, percutaneous coronary interventions and coronary artery bypass graft can be used. There is a lot of information about surgical techniques for coronary artery complications linked to Kawasaki disease, but minimal information about anesthetic techniques; for this reason, we describe the anesthetic management of a patient who required coronary artery bypass graft, and we present a literature review on the topic.
authors.affiliation: Servicio de Anestesiología Cardiovascular, Instituto Nacional de Cardiología Ignacio Chávez, México DF, México. Electronic address: monicaurriola@hotmail.com.
authors.forename: Mónica
authors.initials: M
authors.lastname: Urriola-Martínez
authors.affiliation: Servicio de Anestesiología Cardiovascular, Instituto Nacional de Cardiología Ignacio Chávez, México DF, México.
authors.forename: Francisco
authors.initials: F
authors.lastname: Molina-Méndez
mesh_terms: D000758:Anesthesia; D002675:Child, Preschool; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000209:etiology* / Q000601:surgery*; D005260:Female; D006801:Humans; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications*
keywords: Aneurismas coronarios; Angioplastia percutánea; Cirugía de revascularización coronaria; Coronary aneurysms; Coronary artery bypass graft; Enfermedad de Kawasaki; Kawasaki disease; Mexico; México; Percutaneous coronary interventions; Vasculitis