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KMID : 0857220040080020394
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Journal of the Korean Pediatric Cardiology Society
2004 Volume.8 No. 2 p.394 ~ p.403
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Nationwide Survey of Coronary Aneurysm in Kawasaki Disease
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Jang Gi-Young
Noh Chang-Soo
Kang I-Seok
Park In-Sook
Yun Yong-Soo
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Abstract
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Purpose: This study was performed to elucidate the course of coronary artery lesions caused by Kawasaki disease(KD) and to investigate the mode of diagnosis and therapeutic trends.
Methods: On behalf of Korean Kawasaki disease research committee, we sent a questionnaire to 73 hospitals. One hundred and sixty eight patients with coronary artery aneurysms(>6 mm) caused by KD from 1986 to 2003 were retrospectively analyzed.
Results: Male to female ratio was 3.7 and age at disease onset was 3.6±2.5 years old. Of the 168 patients, there were 121 patients with typical KD and 26 patients with atypical KD. Initial coronary angiography was performed in 115 cases. Average age at initial coronary angiography was 5.7±3.8 years old. The size of aneurysm was 8.1±3.6 mm. During follow-up, some coronary artery lesions regressed in 15/168(8.9%), however, other aneurysms progressed to become obstructive in 28/168(17%). In these patients, such coronary interventions as percutaneous transluminal coronary angioplasty, stent implantation, and percutaneous transluminal coronary rotational ablation were performed. Of the 168 patients, myocardial infarction was developed in 4 patients(2.4%), death occurred in 3 patients(1.7%) during the follow-up period.
Conclusion: Careful follow-up is crucial for all children with coronary artery lesions caused by KD. Giant aneurysm was likely to progress to become obstructive, even if anti-platelet therapy is given. Other forms of treatment, including coronary interventions or surgery, should be considered in such patients.
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KEYWORD
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Kawasaki disease, Coronary artery aneurysm, Follow-up
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