Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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Long-Term Prognosis for Patients with Kawasaki Disease Complicated by Large Coronary Aneurysm (diameter ≥6 mm)

  • Bang, Ji Seok (Department of Pediatrics, Seoul National University Children's Hospital) ;
  • Kim, Gi Beom (Department of Pediatrics, Seoul National University Children's Hospital) ;
  • Kwon, Bo Sang (Department of Pediatrics, Seoul National University Children's Hospital) ;
  • Song, Mi Kyung (Department of Pediatrics, Seoul National University Children's Hospital) ;
  • An, Hyo Soon (Department of Pediatrics, Seoul National University Boramae Hospital) ;
  • Song, Young Whan (Department of Pediatrics, Bundang Seoul National University Hospital) ;
  • Bae, Eun Jung (Department of Pediatrics, Seoul National University Children's Hospital) ;
  • Noh, Chung Il (Department of Pediatrics, Seoul National University Children's Hospital)
  • Received : 2016.04.21
  • Accepted : 2016.11.29
  • Published : 2017.07.31
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Abstract

Background and Objectives: Some patients with Kawasaki disease (KD) develop large coronary aneurysms and subsequent coronary stenosis or obstruction, leading to ischemic heart disease. This study examined the long-term outcomes of patients with KD complicated by large coronary aneurysms. Subjects and Methods: The medical records of 71 patients (53 men and 18 women) diagnosed with large coronary aneurysms (diameter ${\geq}6mm$) between December 1986 and December 2013 were retrospectively reviewed from our institutional database. Results: The mean age at onset was $4.6{\pm}3.3$ years, and the mean follow-up duration was $12.5{\pm}6.9$ years. Maximum coronary artery internal diameter ranged from 6.1 to 25 mm. Giant coronary aneurysms occurred in 48 patients and coronary aneurysms 6-8 mm in diameter developed in 23 patients. Coronary stenosis and/or complete occlusion occurred in 30 patients (42.3%). Catheter and/or surgical interventions (mean: 1.5 interventions, range: 1-5 interventions) were performed in 20 patients (28.2%), 9 months to 18 years after KD onset, resulting in 33.7% cumulative coronary intervention rates at 20 years after onset. There were no differences in cumulative coronary intervention rates between two coronary aneurysm groups (6-8 mm vs. ${\geq}8mm$). Myocardial infarction occurred in 7 patients with a giant aneurysm and there was one death. Conclusions: Long-term survival of patients with KD complicated by large coronary aneurysm was good even though 28.2% of patients underwent multiple catheter or surgical interventions. Careful follow-up is also necessary in KD patients with coronary aneurysms 6-8 mm in diameter, such as those with giant aneurysms.

Keywords

References

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