Abstract
Background: The purpose of this study was to assess the long-term clinical outcome of coronary artery bypass grafting in pediatric patients with Kawasaki disease. Methods: Six patients (mean age, 9.3±1.6 years) underwent coronary artery bypass graft ing be tween September 1985 and December 1992. The number of bypass grafts placed was 1-2/patient(mean of 1.3±0.5). The left internal mammary artery (IMA) was used as a bypass graft in 3 patients, bilateral IMA in 1 and saphenous vein in 3. All pa t ients underw e nt postoperative evaluations after one month, and between 5 and 10 years.Results: Follow-up ranged between 9 and 16 years (mean,12.6±2.7 years). Stress myocardial scintigraphy identified two patients with transient ischemia, one o f w hom died suddenly a ft er 16 postoperative years. Coronary angiography demonstrated that the grafts of 5 patients were patent at both the short- and long-term follow-ups. However, in one patient, the IMA that was grafted to the diagonal artery was occ l ude d one month after su rgery. Five survivors are in good health without clinical angina. Conclusions: We consider that coronary revascularization using bilateral IMA grafts may provide a more favorable prognosis in patients with severe Kawasaki coronary artery disease. Stre ss myocardial scintigraphy and echocardiography can be used effectively to follow such patients.
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Inoue, T., Oku, H. Follow-up Study of Coronary Artery Bypass Grafting in Patients with Kawasaki Disease. Pediatr Res 53, 186 (2003). https://doi.org/10.1203/00006450-200301000-00197
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DOI: https://doi.org/10.1203/00006450-200301000-00197