title: Strict management of a pregnant patient with giant coronary artery aneurysm due to Kawasaki disease.
abstract: Coronary artery aneurysms (CAA) may occur in Kawasaki disease (KD). Patients with giant CAA (diameter >8 mm), in particular, have higher risk of myocardial infarction. Previous reports have demonstrated the necessity of anticoagulation therapy in such cases. The management of patients with KD complicated by giant CAA later in life, however, remains controversial. Here, we describe the strict management in the case of a 28-year-old pregnant Japanese woman with KD with giant CAA (diameter, 11 mm). Instead of warfarin, the patient was given low-dose aspirin and i.v. unfractionated heparin during pregnancy to prevent thrombosis in the giant CAA. At 38 weeks of gestation, she had spontaneous delivery of a healthy baby. No thrombotic or bleeding complications were observed. The strict anticoagulation therapy resulted in successful pregnancy and delivery without any adverse events.
authors.affiliation: Center of Maternal-Fetal, Neonatal and Reproductive Medicine.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Taniguchi
authors.affiliation: Division of Cardiology, National Center for Child Health and Development, Setagaya, Tokyo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ono
authors.affiliation: Center of Maternal-Fetal, Neonatal and Reproductive Medicine.
authors.forename: Anna
authors.initials: A
authors.lastname: Sato
authors.affiliation: Center of Maternal-Fetal, Neonatal and Reproductive Medicine.
authors.forename: Satoko
authors.initials: S
authors.lastname: Kinomoto
authors.affiliation: Center of Maternal-Fetal, Neonatal and Reproductive Medicine.
authors.forename: Naomi
authors.initials: N
authors.lastname: Tagawa
authors.affiliation: Center of Maternal-Fetal, Neonatal and Reproductive Medicine.
authors.forename: Nagayoshi
authors.initials: N
authors.lastname: Umehara
authors.affiliation: Division of Cardiology, National Center for Child Health and Development, Setagaya, Tokyo, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Kato
authors.affiliation: Center of Maternal-Fetal, Neonatal and Reproductive Medicine.
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Sago
mesh_terms: D000328:Adult; D000072226:Computed Tomography Angiography; D003323:Coronary Aneurysm / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D019468:Disease Management; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D011256:Pregnancy Outcome
keywords: Kawasaki disease; coronary aneurysm; low-dose aspirin; pregnancy; unfractionated heparin