|
KMID : 0368120170470040516
|
|
Korean Circulation Journal
2017 Volume.47 No. 4 p.516 ~ p.522
|
|
|
Long-Term Prognosis for Patients with Kawasaki Disease Complicated by Large Coronary Aneurysm (diameter ≥6 mm)
|
|
Bang Ji-Seok
Kim Gi-Beom
Kwon Bo-Sang
Song Mi-Kyung
An Hyo-Soon
Song Young-Whan
Bae Eun-Jung
Noh Chung-Il
|
|
|
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 ≥6 mm) between December 1986 and December 2013 were retrospectively reviewed from our institutional database.
Results: The mean age at onset was 4.6±3.3 years, and the mean follow-up duration was 12.5±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. ≥8 mm). 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.
|
|
|
KEYWORD
|
|
|
Mucocutaneous lymph node syndrome, Coronary aneurysm, Myocardial infarction, Prognosis
|
|
|
FullTexts / Linksout information
|
|
|
|
|
Listed journal information
|
|
   
|