Left main coronary thrombosis after radiofrequency ablation: Successful treatment with percutaneous transluminal angioplasty

Abstract

patible with Kawasaki disease or history consistent with vasculitis or trauma to the chest. As a result of the patients ' acute coronary syndrome and high-grade obstruction of the LMCA, surgical revascularization was undertaken with both internal mammary arteries. The left internal mammary artery was anastomosed to the LAD coronary artery. The right internal mammary artery was taken to the intermediate vessel. As to the best approach to the coronary artery aneurysm, the consensus was to avoid direct approach to or ligation of the aneurysm. There was concern about distal embolization of thrombus present in the aneurysm preoperatively. We were also of the opinion that risk of embolization would be low if retrograde flow from the distal anastomosis of the grafts exceeded forward flow through the critical stenosis in the distal portion of the aneurysm. A careful search for the cause of these coronary artery aneurysms has been made and, similar to other reported cases, we believe that this case may represent sequelae of an unrecognized case of Kawasaki disease and one of the 3 % of those cases which result in ischemic heart disease. Because there are no serologic markers for Kawasaki disease, this assertion is impossible to prove at this time; however, the angiographic appearance of these lesions is certainly compatible with known cases previously described#