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Children 2019, 6(2), 16; https://doi.org/10.3390/children6020016

Significance of Coronary Revascularization for Coronary-Artery Obstructive Lesions Due to Kawasaki Disease

1
Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka 565-8565, Japan
2
Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Suita, Osaka 565-8565, Japan
*
Author to whom correspondence should be addressed.
Received: 5 December 2018 / Revised: 21 January 2019 / Accepted: 24 January 2019 / Published: 29 January 2019
(This article belongs to the Special Issue Kawasaki Disease in Children and Adolescents)
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Abstract

As an acquired ischemic heart disease in childhood, coronary-artery disease caused by Kawasaki disease (KD) has been known worldwide since the mid-1970s. KD patients who develop coronary-artery obstructive disease often need revascularization some time in their life. Coronary-artery revascularization for KD coronary lesions can be done with the surgical coronary-artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) procedures. However, the characteristics of coronary-arterial lesions caused by KD significantly differ from atherosclerotic coronary disease in adults. Therefore, it is much more difficult to determine the optimal time and selection of a coronary-artery revascularization procedure for KD sequelae. CABG using the internal thoracic artery has been accepted as a very useful and beneficial procedure since the mid-1980s, even in small children. Although the use of PCI in the late period can be effective in some adolescent and adult patients, the small vessel size and severe coronary-artery calcification are often limiting factors for its use in children. Therefore, CABG is a better approach for severe leftanterior descending artery and multiple-vessel disease in children and adolescents with KD coronary sequelae. Good coronary revascularization can improve the long-term outcomes of patients with severe KD complications. View Full-Text
Keywords: Kawasaki disease; coronary-artery bypass grafting (CABG); percutaneous coronary intervention (PCI); coronary-artery aneurysm; internal thoracic artery; myocardial infarction Kawasaki disease; coronary-artery bypass grafting (CABG); percutaneous coronary intervention (PCI); coronary-artery aneurysm; internal thoracic artery; myocardial infarction
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Kitamura, S.; Tsuda, E. Significance of Coronary Revascularization for Coronary-Artery Obstructive Lesions Due to Kawasaki Disease. Children 2019, 6, 16.

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