Why the study?
What are the morphologic changes of coronary aneurysms over time in patients with Kawasaki disease receiving anticoagulants?
What are the morphologic changes of coronary aneurysms over time in patients with Kawasaki disease receiving anticoagulants?
Multiple large coronary aneurysms in Kawasaki disease do not heal but transform via thrombosis and calcification despite anticoagulant therapy.
Aneurysms in Kawasaki disease warrant ongoing surveillance despite anticoagulation; case reports leave open optimal long-term strategies for prospective study.
The fate of coronary aneurysms in Kawasaki disease or MCLS was examined by follow‐up studies on 9 patients with multiple bilateral aneurysms in the coronary arteries demonstrated by coronary arteriography. Their ages at the time if first examination ranged from 0.3 to 11 years (mean, 4.1 years). The mean interval between the onset of acute illness and the initial examination was 15.8 months, and the mean interval between the first and second examination was 17.9 months. Eight of the nine patients received anticoagulants between examinations. The second coronary arteriogram showed morphologic changes of the aneueysm from the time of the first examination: changes were seen in the right coronary artery area in 8 patients (89%) and in the left coronary artery area in 7 patients. These morphologuic changes seemed to be mainly secondary to thrombus formation, calcification, stenosis and/or obstruction of the aneuryms. Thus, coronary aneuryms in Kawasaki disease were transformed despite the use of anticoagulants. It is considered that multiple large coronary aneurysms will not healed or disappear, but are simply transformed as a result of their thrombosis and/or calcification.
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Kawachi et al. (1983) studied this question.
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