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

Figures

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  Figure 1. Selective coronary angiogram of the left coronary artery before operation. A seven-year-old Serbian girl who had had Kawasaki disease (KD) at infancy developed localized tight stenosis just at the proximal portion of the left anterior descending artery.

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  Figure 2. Findings of the treadmill testing before and after surgery. (a) Before surgery. During exercise, a seven-year-old Serbian girl had ST-T depression in leads V1–4 due to severe localized stenosis of the left anterior descending artery, as shown in Figure 1. (b) After surgery. ST-T depression in leads V1–4 disappeared after internal thoracic artery (ITA) grafting to the left anterior descending artery, as shown in Figure 3.

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  Figure 3. A computed tomography angiogram 10 days after coronary-artery bypass grafting revealed a well-patented ITA graft to the left anterior descending artery (same patient as shown in Figure 1 and Figure 2).

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  Figure 4. Gastroepiploic-artery (GEA) graft 11 months after surgery. A six-year-old boy had grafting of the posterior descending branch of the right coronary artery with GEA.

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  Figure 5. Selective angiograms 34 years after coronary-artery bypass grafting (CABG). This male patient had surgery at the age of six years old. The saphenous vein graft and internal thoracic-artery graft demonstrated patency. Both the left main coronary artery and the right coronary orifice were asymptomatically occluded during the late period after the surgery (this was the first case to use an ITA in a child) [26].

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  Figure 6. Comparison of survival rates of patients with previous myocardial infarction between the successful CABG group and nongrafting group.

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  Figure 7. Changes in the degree of stenosis after percutaneous transluminal coronary rotational atherectomy (PTCRA). In a 15-year-old boy, good patency of the left circumflex was maintained after repercutaneous transluminal coronary rotational atherectomy (PTCRA).