title: Changes in coronary perfusion after occlusion of coronary arteries in Kawasaki disease.
abstract: OBJECTIVE
  Myocardial infarction in children with total occlusion of a coronary artery after Kawasaki disease is rare due to multiple collateral vessels. We aimed to investigate the changes in coronary perfusion associated with coronary artery occlusion after Kawasaki disease.
  
  
  METHODS
  Eleven patients with coronary artery occlusion after Kawasaki disease were investigated. Serial coronary angiographies after total occlusion of a coronary artery were reviewed and the changes were described in all patients with additive information collected.
  
  
  RESULTS
  The median age at the occlusion was 5.9 years old. The interval to occlusion was 6.2±6.9 years. Four left anterior descending coronary artery total occlusions and 10 right coronary artery total occlusions were detected. Immediate coronary artery bypass graft for left anterior descending coronary artery total occlusion made right coronary total occlusion occurred in all except one patient and the intervals thereof were 1 year, 1.8 years, and 4 years. Collaterals to the left coronary artery regressed after recanalization, while new collaterals to the right coronary artery developed. In three, collaterals to the right coronary artery decreased without recanalization without clinical signs.
  
  
  CONCLUSIONS
  The right coronary artery should be followed up carefully because of possible occlusion of new onset or changes in collaterals.
authors.affiliation: Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Korea. amyjys@naver.com.
authors.forename: Ji Hee
authors.initials: JH
authors.lastname: Kwak
authors.forename: Jinyoung
authors.initials: J
authors.lastname: Song
authors.forename: I-Seok
authors.initials: IS
authors.lastname: Kang
authors.forename: June
authors.initials: J
authors.lastname: Huh
authors.forename: Heung-Jae
authors.initials: HJ
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D054059:Coronary Occlusion / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications / Q000503:physiopathology*
keywords: Kawasaki disease; coronary angiography; coronary collaterals; coronary occlusion