Surgical Treatment of Coronary Artery Lesions in Kawasaki Disease

Abstract

The surgical treatment of coronary artery lesions in Kawasaki disease is reviewed. Surgical treatment of coronary obstructive lesions in Kawasaki disease has been performed using autologous saphenous vein grafts and arterial grafts, mainly from internal thoracic artery, when there is substantial myocardium in ischemia or at risk of infarction and the distal coronary artery is graftable. A recent multiinstitutional study conducted in Japan has shown that the mortality and morbidity of coronary artery bypass surgery for coronary lesions in Kawasaki disease are acceptably low, and the long-term results have improved with use of arterial grafts, especially for young patients. However, the precise role of coronary bypass surgery in the treatment of coronary artery lesions in Kawasaki disease is still to be determined by comparisons of natural prognosis, long-term results of medical management including percutaneous transluminal coronary angioplasty, and the long-term results of evolving surgery.