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Published in: Journal of Medical Case Reports 1/2012

Open Access 01-12-2012 | Case report

Stent implantation for a totally occluded right coronary artery in a six-year-old boy after Kawasaki disease: a case report

Authors: Ya-Chi Hsu, Kae-Woei Liang, Ming-Chih Lin, Yun-Ching Fu, Sheng-Ling Jan

Published in: Journal of Medical Case Reports | Issue 1/2012

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Abstract

Introduction

Coronary stenting has previously been considered to be less feasible in children under 12 years old due to the limitation of vascular access. We report the case of a six-year-old boy who successfully underwent stent implantation for his totally occluded right coronary artery.

Case presentation

A Taiwanese boy aged six years and nine months old was found to have giant aneurysms after an acute episode of Kawasaki disease. An angiography revealed that his middle right coronary artery was totally occluded. A 0.014-inch guidewire was advanced to cross the totally occluded site. After pre-dilating the middle portion of his right coronary artery with a 1.5 mm balloon, stenting of his right coronary artery was accomplished using a 2.5 × 28 mm and a 2.5 × 18 mm bare metal stent. A final angiography demonstrated no residual stenosis or dissection.

Conclusion

Coronary stenting could be a therapeutic option for children as young as six years old. Close follow-up is mandatory because the long-term outcome is still unclear, especially in a small child.
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Literature
1.
go back to reference McCrindle BW, Li JS, Minich LL, Colan SD, Atz AM, Takahashi M, Vetter VL, Gersony WM, Mitchell PD, Newburger JW: Coronary artery involvement in children with Kawasaki disease: risk factors from analysis of serial normalized measurements. Circulation. 2007, 116: 174-179. 10.1161/CIRCULATIONAHA.107.690875.CrossRefPubMed McCrindle BW, Li JS, Minich LL, Colan SD, Atz AM, Takahashi M, Vetter VL, Gersony WM, Mitchell PD, Newburger JW: Coronary artery involvement in children with Kawasaki disease: risk factors from analysis of serial normalized measurements. Circulation. 2007, 116: 174-179. 10.1161/CIRCULATIONAHA.107.690875.CrossRefPubMed
2.
go back to reference Akagi T: Interventions in Kawasaki disease. Pediatr Cardiol. 2005, 26: 206-212. 10.1007/s00246-004-0964-2.CrossRefPubMed Akagi T: Interventions in Kawasaki disease. Pediatr Cardiol. 2005, 26: 206-212. 10.1007/s00246-004-0964-2.CrossRefPubMed
3.
go back to reference Lin MC, Hsu CM, Fu YC: Giant coronary aneurysms developed in a child of Kawasaki disease with only 3 days of fever. Cardiol Young. 2010, 20: 339-341. 10.1017/S104795111000017X.CrossRefPubMed Lin MC, Hsu CM, Fu YC: Giant coronary aneurysms developed in a child of Kawasaki disease with only 3 days of fever. Cardiol Young. 2010, 20: 339-341. 10.1017/S104795111000017X.CrossRefPubMed
4.
go back to reference Muta H, Ishii M: Percutaneous coronary intervention versus coronary artery bypass grafting for stenotic lesions after Kawasaki disease. J Pediatr. 2010, 157: 120-126. 10.1016/j.jpeds.2010.01.032.CrossRefPubMed Muta H, Ishii M: Percutaneous coronary intervention versus coronary artery bypass grafting for stenotic lesions after Kawasaki disease. J Pediatr. 2010, 157: 120-126. 10.1016/j.jpeds.2010.01.032.CrossRefPubMed
5.
go back to reference Akagi T, Ogawa S, Ino T, Iwasa M, Echigo S, Kishida K, Baba K, Matsushima M, Hamaoka K, Tomita H, Ishii M, Kato H: Catheter interventional treatment in Kawasaki disease: a report from the Japanese Pediatric Interventional Cardiology Investigation group. J Pediatr. 2000, 137: 181-186. 10.1067/mpd.2000.107164.CrossRefPubMed Akagi T, Ogawa S, Ino T, Iwasa M, Echigo S, Kishida K, Baba K, Matsushima M, Hamaoka K, Tomita H, Ishii M, Kato H: Catheter interventional treatment in Kawasaki disease: a report from the Japanese Pediatric Interventional Cardiology Investigation group. J Pediatr. 2000, 137: 181-186. 10.1067/mpd.2000.107164.CrossRefPubMed
6.
go back to reference Ishii M, Ueno T, Akagi T, Baba K, Harada K, Hamaoka K, Kato H, Tsuda E, Uemura S, Saji T, Ogawa S, Echigo S, Yamaguchi T, Kato H, Research Committee of Ministry of Health, Labour and Welfare--"Study of treatment and long-term management in Kawasaki disease": Guidelines for catheter intervention in coronary artery lesion in Kawasaki disease. Pediatr Int. 2001, 43: 558-562. 10.1046/j.1442-200X.2001.01464.x.CrossRefPubMed Ishii M, Ueno T, Akagi T, Baba K, Harada K, Hamaoka K, Kato H, Tsuda E, Uemura S, Saji T, Ogawa S, Echigo S, Yamaguchi T, Kato H, Research Committee of Ministry of Health, Labour and Welfare--"Study of treatment and long-term management in Kawasaki disease": Guidelines for catheter intervention in coronary artery lesion in Kawasaki disease. Pediatr Int. 2001, 43: 558-562. 10.1046/j.1442-200X.2001.01464.x.CrossRefPubMed
7.
go back to reference King SB, Smith SC, Hirshfeld JW, Jacobs AK, Morrison DA, Williams DO, Feldman TE, Kern MJ, O'Neill WW, Schaff HV, Whitlow PL, ACC/AHA/SCAI, Adams CD, Anderson JL, Buller CE, Creager MA, Ettinger SM, Halperin JL, Hunt SA, Krumholz HM, Kushner FG, Lytle BW, Nishimura R, Page RL, Riegel B, Tarkington LG, Yancy CW: 2007 focused update of the ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention: a report of the American College of Cardiology/American Heart Association Task Force on Practice guidelines. J Am Coll Cardiol. 2008, 51: 172-209. 10.1016/j.jacc.2007.10.002.CrossRefPubMed King SB, Smith SC, Hirshfeld JW, Jacobs AK, Morrison DA, Williams DO, Feldman TE, Kern MJ, O'Neill WW, Schaff HV, Whitlow PL, ACC/AHA/SCAI, Adams CD, Anderson JL, Buller CE, Creager MA, Ettinger SM, Halperin JL, Hunt SA, Krumholz HM, Kushner FG, Lytle BW, Nishimura R, Page RL, Riegel B, Tarkington LG, Yancy CW: 2007 focused update of the ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention: a report of the American College of Cardiology/American Heart Association Task Force on Practice guidelines. J Am Coll Cardiol. 2008, 51: 172-209. 10.1016/j.jacc.2007.10.002.CrossRefPubMed
8.
go back to reference Tsuda E, Fujita H, Yagihara T, Yamada O, Echigo S, Kitamura S: Competition between native flow and graft flow after coronary artery bypass grafting. Impact on indications for coronary artery bypass grafting for localized stenosis with giant aneurysms due to Kawasaki disease. Pediatr Cardiol. 2008, 29: 266-270. 10.1007/s00246-007-9114-y.CrossRefPubMed Tsuda E, Fujita H, Yagihara T, Yamada O, Echigo S, Kitamura S: Competition between native flow and graft flow after coronary artery bypass grafting. Impact on indications for coronary artery bypass grafting for localized stenosis with giant aneurysms due to Kawasaki disease. Pediatr Cardiol. 2008, 29: 266-270. 10.1007/s00246-007-9114-y.CrossRefPubMed
9.
go back to reference Ishii M, Ueno T, Ikeda H, Iemura M, Sugimura T, Furui J, Sugahara Y, Muta H, Akagi T, Nomura Y, Homma T, Yokoi H, Nobuyoshi M, Matsuishi T, Kato H: Sequential follow-up results of catheter intervention for coronary artery lesions after Kawasaki disease: quantitative coronary artery angiography and intravascular ultrasound imaging study. Circulation. 2002, 105: 3004-3010. 10.1161/01.CIR.0000019733.56553.D8.CrossRefPubMed Ishii M, Ueno T, Ikeda H, Iemura M, Sugimura T, Furui J, Sugahara Y, Muta H, Akagi T, Nomura Y, Homma T, Yokoi H, Nobuyoshi M, Matsuishi T, Kato H: Sequential follow-up results of catheter intervention for coronary artery lesions after Kawasaki disease: quantitative coronary artery angiography and intravascular ultrasound imaging study. Circulation. 2002, 105: 3004-3010. 10.1161/01.CIR.0000019733.56553.D8.CrossRefPubMed
10.
go back to reference Waki K, Baba K: Transcatheter polytetrafluoroethylene-covered stent implantation in a giant coronary artery aneurysm of a child with Kawasaki disease--a potential novel treatment. Catheter Cardiovasc Interv. 2006, 68: 74-77. 10.1002/ccd.20808.CrossRefPubMed Waki K, Baba K: Transcatheter polytetrafluoroethylene-covered stent implantation in a giant coronary artery aneurysm of a child with Kawasaki disease--a potential novel treatment. Catheter Cardiovasc Interv. 2006, 68: 74-77. 10.1002/ccd.20808.CrossRefPubMed
11.
go back to reference Li SS, Cheng BC, Lee SH: Images in cardiovascular medicine. Giant coronary aneurysm formation after sirolimus-eluting stent implantation in Kawasaki disease. Circulation. 2005, 112: e105-107. 10.1161/CIRCULATIONAHA.104.503300.CrossRefPubMed Li SS, Cheng BC, Lee SH: Images in cardiovascular medicine. Giant coronary aneurysm formation after sirolimus-eluting stent implantation in Kawasaki disease. Circulation. 2005, 112: e105-107. 10.1161/CIRCULATIONAHA.104.503300.CrossRefPubMed
Metadata
Title
Stent implantation for a totally occluded right coronary artery in a six-year-old boy after Kawasaki disease: a case report
Authors
Ya-Chi Hsu
Kae-Woei Liang
Ming-Chih Lin
Yun-Ching Fu
Sheng-Ling Jan
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2012
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/1752-1947-6-111

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