Single Center Outcome of Coronary Artery Bypass Grafring for Kawasaki Disease Mainly with Arterial Graft Revascularization
Woo Sik Han, Min Soo Kim, MD, Jongbae Son, MD, Dong Seop Jeong, MD, PhD, Pyo Won Park, MD, PhD, Young Tak Lee, MD, PhD.
Seoul Samsung Medical Center, Seoul, Korea, Republic of.
OBJECTIVE: The aim of this study was to evaluate the midterm results of coronary artery bypass grafting (CABG) for stenotic lesions by Kawasaki disease (KD)
METHODS: From 2002 to 2014, 20 patients with stenotic coronary lesions caused by KD underwent CABG. Basic operative strategies were Off-pump coronary bypass grafting (OPCAB) with arterial graft revascularization. All clinical data and outcomes were retrospectively reviewed.
RESULTS: There were 4 male (20%) and 16 female (80%) patients with age at operation ranging from2 to 42 (median, 17.5) years. The mean numbers of bypass grafts per patients was 1.7+/-0.6 (range, 1 to 3) and grafted target vessels per patients was 2.2+/-1.1(range, 1 to 4). The left internal thoracic arteries (LITA) were used in 19 patients and right internal thoracic arteries (RITA) were grafted in 10 patients. Gastroepiploic arteries (GEA) and saphenous vein grafts (SVG) were used in 3 and 1 patients respectively. Mean follow-up duration from the operation was 59.5+/-48.5 months (range, 1 to 159 months). There was no early and late mortality. Among 20 patients, 2 patients underwent re-intervention with balloon angioplasty due to graft failure. A patient also had graft failure but re-intervention was not performed. Two other patients underwent intervention due to new obstructive lesions that were not significant at the initial operation. OF the latter two, one was done by the percutaneous transluminal rotational ablation and another was done by re-do operation. All patients but one are in good clinical condition without significant angina
CONCLUSIONS: OPCAB with mainly arterial graft revascularization can be considered a good surgical option for coronary lesions caused by KD.
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