Published online Nov 6, 2020. doi: 10.12998/wjcc.v8.i21.5457
Peer-review started: June 27, 2020
First decision: June 13, 2020
Revised: September 4, 2020
Accepted: September 28, 2020
Article in press: September 28, 2020
Published online: November 6, 2020
Processing time: 156 Days and 6.6 Hours
Kawasaki disease (KD) is an acute systemic vasculitis characterized by unknown etiology.
A 4.5-year-old boy developed an acute abdomen during the onset of incomplete KD. He still had persistent abdominal pain after undergoing exploratory laparotomy and appendectomy. Ultrasound examination at early onset revealed a giant coronary artery aneurysm. The patient developed a myocardial infarction and heart failure accompanied by respiratory and cardiac arrest. He underwent coronary artery revascularization and coronary artery bypass graft using an autologous internal mammary artery. After the operation, the cardiac output increased, and the symptoms of heart failure resolved. Follow-up evaluation at 1 mo after operation showed that the patient's cardiac function had restored to New York Heart Association standard Grade I heart failure, and normal growth was obtained.
Coronary artery revascularization and coronary artery bypass graft is an effective method for treating myocardial ischemia in children with KD complicated with giant coronary artery aneurysm . Nevertheless, some issues still need specific attention.
Core Tip: Large-scale epidemiologic investigations and studies with long-term follow-up about coronary artery bypass graft in patients with Kawasaki disease have been rarely reported. At present, anastomosis of the left internal mammary artery with left anterior descending coronary artery is considered to be the optimal bypass grafting technique, as it yields satisfactory long-term patency and survival rates.