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General Thoracic and Cardiovascular Surgery
Published in: General Thoracic and Cardiovascular Surgery 3/2018

01-03-2018 | Current Topics Review Article

Review: surgical treatment of giant coronary aneurysms in pediatric patients with Kawasaki disease

Author: Masami Ochi

Published in: General Thoracic and Cardiovascular Surgery | Issue 3/2018

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Abstract

In Kawasaki disease (KD), giant coronary aneurysms in the proximal segments of the coronary arteries have long been among the serious complications associated with acute myocardial infarction. To treat myocardial ischemia in children, Kitamura et al. first performed coronary artery bypass grafting in a pediatric patient using an autologous saphenous vein. In the early 1980s, they began to use the internal thoracic artery (ITA) as a bypass graft to the left anterior descending artery, which later was proven to improve long-term life expectancy with its favorable long-term patency, as well as growth potential. Thus, the excellent characteristics of the ITA have come to be widely known among pediatric cardiac surgeons, and a growing number of coronary bypass surgery procedures using the ITA are now being performed worldwide. Although a longer follow-up with more patients is necessary, downsizing reconstructive procedure may be a treatment of choice for giant aneurysms of non-LAD territories to improve coronary circulation. The efficacy of surgical treatment for giant coronary aneurysms in pediatric patients with Kawasaki disease is now well established. Pediatric coronary artery bypass grafting using the ITA, either single or bilateral, can be safe not only for patients with Kawasaki coronary disease but also for infants with congenital coronary lesions.
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Metadata
Title
Review: surgical treatment of giant coronary aneurysms in pediatric patients with Kawasaki disease
Author
Masami Ochi
Publication date
01-03-2018
Publisher
Springer Japan
Published in
General Thoracic and Cardiovascular Surgery / Issue 3/2018
Print ISSN: 1863-6705
Electronic ISSN: 1863-6713
DOI
https://doi.org/10.1007/s11748-017-0877-7

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