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Surgical management for cardiovascular lesions in Kawasaki disease

Published online by Cambridge University Press:  19 August 2008

Soichiro Kitamura
Soichiro Kitamura*
Affiliation:
Department of Surgery III, Nara Medical College, Nara
*
Dr. Soichiro Kitamura, Department of Surgery 111, Nara Medical College, 840 Shijo-cho, Kashihara, Nara, 634Japan
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Summary

Summary Myocardial revascularization is now an accepted therapeutic modality for severe coronary arterial obstructive disease produced by Kawasaki disease which is amenable to usual medical treatment. The mortality rate of myocardial infarction is surprisingly high in this setting, and surgery may be able to prevent many of these deaths. This article focuses on current issues in surgical treatment of ischemic heart disease in children secondary to Kawasaki disease. Coronary arterial obstructive disease is, apparently, a leading problem followed by valvar and myocardial involvements. Introduction of bypass grafting using the internal thoracic artery in children was a major recent advance, because this graft has an excellent capability to adapt to the increments of increased flow and growth of the patient. The saphenous vein is less satisfactory when used as a graft in terms of its long-term patency, particularly in young children less than 8 years old. Although longer follow-up is certainly required, the current results of surgery have been excellent in improving myocardial perfusion, in ameliorating symptoms, and improving the quality of life.

Type
The World Forum for Pediatric Cardiology Symposium on Kawasaki Disease
Information
Cardiology in the Young , Volume 1 , Issue 3 , July 1991 , pp. 240 - 253
Copyright
Copyright © Cambridge University Press 1991

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