Abstract
Typically, Kavasaki syndrome occurs in children under the age 5 years and it can be reason for acquired heart
disease (pericarditis, myocarditis, valvular lesions of the heart). In 25% of patients with Kawasaki disease
during the follow-up characterized by the formation coronary artery aneurysms and calcified stenosis, leading
to the development of coronary heart disease and myocardial infarction in childhood and young age.
In this case report, we describe 5 year old child who underwent off-pump coronary artery bypass grafting for
LAD with subtotal stenosis on input of a giant aneurysm. At the age of 3 patient was diagnosed as Kawasaki
disease with giant coronary artery aneurysm in the left anterior descending artery and small aneurysm of the
right coronary artery. Patient was continuously followed-up for 2 years under restrictive anticoagulation therapy
until a critical stenotic lesion in the LAD were recognized. He underwent coronary artery bypass grafting
on a beating heart. Left internal thoracic artery was anastomosed to the left descending artery. Multiple
calcified areas of the coronary arteries was found during operation. Shuntography showed complete patency
of the formed anastomosis. The patient was discharged in stable condition at the day 7 after operation.
This case demonstrates that off-pump coronary artery bypass grafting using LIMA was a safe and reliable
surgical method for 5 years old child with a critical stenosis at the input of giant aneurism of LAD. However,
this operation requires a good preparation, both the child and the cardiovascular surgeon that repeatedly was
performed in Bakoulev National Scientific and Practical Center for Cardiovascular Surgery.
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