title: Feasibility of optical coherence tomography in children with Kawasaki disease and pediatric heart transplant recipients.
abstract: BACKGROUND
  Optical coherence tomography (OCT) is a high-resolution intravascular imaging technique used in adults. We tested the hypothesis that OCT could identify coronary abnormalities not seen by angiography in children with a history of Kawasaki disease (KD) and pediatric heart transplant (TX) recipients.
  
  
  RESULTS
  Patients with KD and TX recipients were evaluated between December 2012 and October 2013 with angiography and OCT (Ilumien System, LightLabs, St Jude Medical, Westford, MA). Modifications were made to the adult OCT protocol to adapt this technique for children. Serial cross-sectional area measurements of the lumen, intima, and media were made. Entire imaging data were analyzed for the presence of qualitative changes. Seventeen children were evaluated (5 patients with KD; 12 TX recipients). In patients with KD, angiography was normal. However, OCT imaging revealed that significant vessel wall abnormalities were present in all children including intimal thickening (intima/lumen cross-sectional area ratio>0.4), loss of the normal layered structure of the vessel wall, white thrombus, calcification, and neovascularization. There was extensive destruction of the internal elastic lamina. In TX recipients, angiography was normal; however, intimal thickening (intima/media cross-sectional area ratio>1) was seen in 9 of 12 patients. The median intima/media cross-sectional area ratio was 1.18.
  
  
  CONCLUSIONS
  In this initial experience with OCT in children, we have identified significant coronary abnormalities with OCT that are angiographically silent in children with a history of coronary aneurysms because of KD and in pediatric TX recipients.
authors.affiliation: From the Division of Pediatric Cardiology, Department of Pediatrics (K.C.H., A.M., A.D.S., J.E.P., M.C.K.H.) and Division of Cardiology, Department of Medicine (A.Y.F.), University of British Columbia, Vancouver, Canada; and Division of Cardiology, Department of Medicine, Case Western Reserve University, Cleveland, OH (H.G.B.). kharris2@cw.bc.ca.
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Harris
authors.affiliation: From the Division of Pediatric Cardiology, Department of Pediatrics (K.C.H., A.M., A.D.S., J.E.P., M.C.K.H.) and Division of Cardiology, Department of Medicine (A.Y.F.), University of British Columbia, Vancouver, Canada; and Division of Cardiology, Department of Medicine, Case Western Reserve University, Cleveland, OH (H.G.B.).
authors.forename: Anas
authors.initials: A
authors.lastname: Manouzi
authors.affiliation: From the Division of Pediatric Cardiology, Department of Pediatrics (K.C.H., A.M., A.D.S., J.E.P., M.C.K.H.) and Division of Cardiology, Department of Medicine (A.Y.F.), University of British Columbia, Vancouver, Canada; and Division of Cardiology, Department of Medicine, Case Western Reserve University, Cleveland, OH (H.G.B.).
authors.forename: Anthony Y
authors.initials: AY
authors.lastname: Fung
authors.affiliation: From the Division of Pediatric Cardiology, Department of Pediatrics (K.C.H., A.M., A.D.S., J.E.P., M.C.K.H.) and Division of Cardiology, Department of Medicine (A.Y.F.), University of British Columbia, Vancouver, Canada; and Division of Cardiology, Department of Medicine, Case Western Reserve University, Cleveland, OH (H.G.B.).
authors.forename: Astrid
authors.initials: A
authors.lastname: De Souza
authors.affiliation: From the Division of Pediatric Cardiology, Department of Pediatrics (K.C.H., A.M., A.D.S., J.E.P., M.C.K.H.) and Division of Cardiology, Department of Medicine (A.Y.F.), University of British Columbia, Vancouver, Canada; and Division of Cardiology, Department of Medicine, Case Western Reserve University, Cleveland, OH (H.G.B.).
authors.forename: Hiram G
authors.initials: HG
authors.lastname: Bezerra
authors.affiliation: From the Division of Pediatric Cardiology, Department of Pediatrics (K.C.H., A.M., A.D.S., J.E.P., M.C.K.H.) and Division of Cardiology, Department of Medicine (A.Y.F.), University of British Columbia, Vancouver, Canada; and Division of Cardiology, Department of Medicine, Case Western Reserve University, Cleveland, OH (H.G.B.).
authors.forename: James E
authors.initials: JE
authors.lastname: Potts
authors.affiliation: From the Division of Pediatric Cardiology, Department of Pediatrics (K.C.H., A.M., A.D.S., J.E.P., M.C.K.H.) and Division of Cardiology, Department of Medicine (A.Y.F.), University of British Columbia, Vancouver, Canada; and Division of Cardiology, Department of Medicine, Case Western Reserve University, Cleveland, OH (H.G.B.).
authors.forename: Martin C K
authors.initials: MC
authors.lastname: Hosking
mesh_terms: D000293:Adolescent; D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D017023:Coronary Angiography; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000175:diagnosis*; D016027:Heart Transplantation; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000175:diagnosis*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013997:Time Factors; D041623:Tomography, Optical Coherence / Q000379:methods*
keywords: Kawasaki disease; coronary disease; heart transplantation; pediatrics