Early and late postoperative studies in coronary arterial lesions resulting from Kawasaki's disease in children

Abstract

From October, 1976, to February, 1980, eight children with coronary arterial lesions resulting from Kawasaki's disease underwent surgical treatment--aorta-coronary bypass, aorta-coronary bypass combined with right coronary aneurysmectomy, and aorta-coronary bypass combined with left ventricular aneurysmectomy. The autogenous saphenous vein was used for the bypass grafts. Selective angiography preformed 1 month after the operation revealed an early patency rate of 85%. Seven patients are now leading a normal school life, but one patient died suddenly during relatively strenuous exercise 3 years after the operation. Angiography performed in five patients 1 to 3 years after the operation and autopsy examination in one decreased patient revealed the late patency rate to be 56%. The relatively higher attrition rate of the grafts in the later stage might be ascribed to the smaller caliber of the coronary artery and saphenous vein, to possible inflammatory changes in both the graft and coronary arteries, or to unknown metabolic differences between children and adults.