Transformation of coronary artery aneurysm to obstructive lesion and the role of collateral vessels in myocardial perfusion in patients with Kawasaki disease
Z Onouchi,
K Hamaoka,
Y Kamiya,
S Hayashi,
Y Ohmochi,
K Sakata,
I Shiraishi,
T Hayano,
and
H Fukumochi
Division of Pediatrics, Children's Research Hospital, Kyoto Prefectural University of Medicine, Japan.
OBJECTIVES. The aim of this study was to examine the transformation of coronary artery aneurysms to obstructive lesions and to assess the role of collateral vessels in patients with Kawasaki disease. BACKGROUND. Coronary artery aneurysms, especially giant aneurysms, are known to become obstructive lesions in patients with Kawasaki disease. However, the process of transformation is not yet clear. METHODS. Thirty patients (average age 9.9 years) with obstructive lesions secondary to Kawasaki disease underwent repeated coronary artery angiography and thallium myocardial scintigraphy over a mean period of 7.7 years after the acute onset of Kawasaki disease. RESULTS. In the 27 patients who were enrolled in the acute phase of the disease because of coronary artery aneurysms, the later transformation to obstructive lesions was not significantly different between the 61 large and 6 medium-sized aneurysms. Obstructive transformation of aneurysms was more rapid in the right than in the left coronary artery (p < 0.001). From the last coronary angiogram obtained, the obstructive lesions were classified as localized stenosis > 90% in 10 vessels, occlusions in 6 vessels and segmental stenosis in 26 vessels. Both localized and segmental stenosis occurred significantly more often in the left anterior descending and the right coronary artery than in other vessels (p < 0.05). The incidence of collateral vessels was significantly correlated with a younger age at onset of Kawasaki disease, especially in patients with segmental stenosis (p < 0.001). Collateral vessels did not develop in the presence of localized stenosis regardless of the occurrence of myocardial ischemia. All occluded vessels had collateral development regardless of the presence of myocardial infarction. CONCLUSIONS. The treatment of localized stenosis may play an important role in preventing myocardial infarction in the chronic phase of Kawasaki disease.
This article has been cited by other articles:
|
|
|
|
 
R. Agarwal, V. Jeevanandam, and N. Jolly
Surgical Treatment of a Giant Coronary Artery Aneurysm: A Modified Approach
Ann. Thorac. Surg.,
October 1, 2007;
84(4):
1392 - 1394.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Ogawa, T. Ohkubo, R. Fukazawa, M. Kamisago, Y. Kuramochi, Y. Uchikoba, E. Ikegami, M. Watanabe, and Y. Katsube
Estimation of myocardial hemodynamics before and after intervention in children with kawasaki disease
J. Am. Coll. Cardiol.,
February 18, 2004;
43(4):
653 - 661.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Tateno, M. Terai, K. Niwa, T. Jibiki, H. Hamada, K. Yasukawa, T. Honda, S. Oana, and Y. Kohno
Alleviation of Myocardial Ischemia After Kawasaki Disease by Heparin and Exercise Therapy
Circulation,
May 29, 2001;
103(21):
2591 - 2597.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S-H Park, S-E Kim, and S K Ryu
Left main coronary artery aneurysm with chronic total occlusion of both left coronary arteries in a young athlete
Heart,
January 1, 2001;
85(1):
1e - 1.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
H. M Y Chia, K. H Tan, and G. Jackson
Non-atherosclerotic coronary artery aneurysms: two case reports
Heart,
December 1, 1997;
78(6):
613 - 616.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Pfafferott, A. Wirtzfeld, and B. Permanetter
Atypical Kawasaki syndrome: how many symptoms have to be present?
Heart,
December 1, 1997;
78(6):
619 - 621.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
