Abstract
Kawasaki disease (KD), or mucocutaneous lymphonodular syndrome, is an acute systemic disease characterized by the development of vasculitis, with frequent compromise of the coronary and other visceral arteries, being the main cause of acquired organic heart lesions in children. The most severe and prognostically unfavorable consequence of KD is the formation of giant aneurysms (GA) of the coronary arteries (CA). The conditions constantly existing in GA for thrombosis and progressive obstructive lesions of the CA are the main predictors of the development of coronary heart disease. Myocardial revascularization is the main method of treatment aimed at preventing severe ischemic complications, 8 coronary artery bypass grafting operations were performed in children with coronary artery disease and GA using various conduits at the Bakoulev National Medical Research Center for Cardiovascular Surgery. performed.
In this report we want to present a retrospective analysis of the causes of conduit dysfunction in two operated patients, taking into account the initial clinical data, as well as the results of the diagnostic methods performed.
References
- Lyskina G.А., Bockeria О.L., Shirinskaya О.G., Gagarina N.V., Satyukova А.S., Torbyak А.V., Kostina Yu.О. Giant aneurisms of coronary arteries in the Kawasaki syndrome. Cardiology. 2017; 57 (5): 76–84 (in Russ.). DOI: 10.18565/cardio.2017.5.76-84
- Kato H., Sugimura T., Akagi T., Sato N., Hashino K., Maeno Y. et al. Long-term consequences of Kawasaki disease. A 10- to 21-year follow-up study of 594 patients. Circulation. 1996; 94: 1379–85.
- JCS Joint Working Group. Guidelines for diagnosis and management of cardiovascular sequelae in Kawasaki disease (JCS 2013). Circ. J. Jpn. Circ. Soc. 2014; 78: 2521–62. DOI: 10.1253/circ.j.cj.-66-0096
- Kato H., Ichinose E., Kawasaki T. Myocardial infarction in Kawasaki disease: clinical analyses in 195 cases. J. Pediatr. 1986; 108: 923–7. DOI: 10.1016/S0022-3476(86)80928-3
- McCrindle B.W., Rowley A.H., Newburger J.W., Burns A., Bolger A.F., Gewitz M. et al. AHA Scientific Statement: diagnosis, treatment, and long-term ma-nagement of Kawasaki disease. A scientific statement for health professionals from the American Heart Association. Circulation. 2017; 135: e927–e999. DOI: 10.1161/CIR.0000000000000484
- Dong Seop Jeong, Woosik Han, Young Tak Lee, Wook Sung Kim, Jinyoung Song, I-Seok Kang, Pyo Won Park. Coronary artery bypass grafting with arterial grafts in patients with Kawasaki disease affecting the coronary artery: a Korean single-center study. J. Korean Med. Sci. 2018; 33 (42): e267. DOI: 10.3346/jkms.2018.33.e267
- Ji Hee Kwak, Jinyoung Song, I-Seok Kang, June Huh, Heung-Jae Lee. Changes in coronary perfusion after occlusion of coronary arteries in Kawasaki disease. Yonsei Med. J. 2014; 55 (2): 353–9.
- Tsuda E., Fujita H., Yagihara T., Yamada O., Echigo S., Kitamura S. Competition between native flow and graft flow after coronary artery bypass grafting. Impact on indications for coronary artery bypass grafting for localized stenosis with giant aneurysms due to Kawasaki disease. Pediatr. Cardiol. 2008; 29 (2): 266–70. DOI: 10.1007/ S00246-007-9114-y
- Kitamura S., Tsuda E., Kobayashi J., Nakajima H., Yoshikawa Y., Yagihara T. et al. Twenty-five year outcome of pediatric coronary artery bypass surgery for Kawasaki disease. Circulation. 2009; 120 (1): 60–8. DOI: 10.1161/CIRCULATIONAHA.108.840603
- Kitamura S. The role of coronary bypass operation on children with Kawasaki disease. Coronary Artery Dis. 2002; 13 (8): 437–47. DOI: 10.1097/00019501-200212000-00009
- Long-term outcomes of pediatric coronary artery bypass grafting and down-sizing operation for giant coronary aneurysms. In: Saji B.Ts., Newburger J.W., Burns J.C., Takahashi M. Kawasaki disease. Springer, Tokyo; 2017: 393.
- Ogawa S., Ohkubo T., Fukazawa R., Kamisago M., Kuramochi Y., Uchikoba Y. et al. Estimation of myocardial hemodynamics before and after intervention in children with Kawasaki disease. J. Am. Coll. Cardiol. 2004; 43 (4): 653–61. DOI: 10.1016/j.jacc.2003.10.032
- Kitamura S. Long-term graft patency and surgical outcomes of coronary artery bypass surgery in children with Kawasaki disease. In: Saji B.T., Newburger J.W., Burns J.C., Takahashi M. (Eds.) Kawasaki disease. Springer, Japan; 2017: 407–17.
About the authors
- Leo A. Bockeria, Academician of the Russian Academy of Sciences, President; ORCID
- Vadim Yu. Merzlyakov, Professor, Head of the Department, Cardiovascular Surgeon; ORCID
- Irina V. Shurupova, Dr. Med. Sci., Professor, Senior Researcher, Radiologist; ORCID
- Ol’ga G. Shirinskaya, Cand. Med. Sci., Ultrasound Diagnostician
- Nina V. Gagarina, Cand. Med. Sci., Radiologist
- Karen V. Petrosyan, Dr. Med. Sci., Head of the Department, Physician of X-ray Endovascular Methods of Diagnosis
and Treatment; ORCID
- Marina Yu. Mironenko, Cand. Med. Sci., Head of Department, Ultrasound Diagnostician; ORCID
- Merab K. Sanakoev, Cand. Med. Sci., Cardiovascular Surgeon; ORCID
- Vitaliy B. Andreev, Cardiologist; ORCID
- Zalina F. Kudzoeva, Cand. Med. Sci., Cardiologist; ORCID
