Multiple Coronary Artery Bypass Grafting for Kawasaki Disease–Associated Coronary Artery Disease
| Autor: | Naoki Tadokoro, Naonori Kawamoto, Soichiro Kitamura, Kizuku Yamashita, Yusuke Shimahara, Junjiro Kobayashi, Satsuki Fukushima, Etsuko Tsuda, Yorihiko Matsumoto, Tomoyuki Fujita |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Databases Factual Bypass grafting medicine.medical_treatment Comorbidity Coronary Artery Disease Kaplan-Meier Estimate 030204 cardiovascular system & hematology Coronary Angiography Cohort Studies Coronary artery disease 0302 clinical medicine Japan Medicine Coronary Artery Bypass Middle Aged Treatment Outcome surgical procedures operative medicine.anatomical_structure Cardiology Female Patient Safety Cardiology and Cardiovascular Medicine Artery Adult Reoperation Pulmonary and Respiratory Medicine medicine.medical_specialty Adolescent Internal thoracic artery Gastroepiploic Artery Mucocutaneous Lymph Node Syndrome Revascularization Risk Assessment Young Adult 03 medical and health sciences medicine.artery Internal medicine Humans cardiovascular diseases Radial artery Proportional Hazards Models Retrospective Studies business.industry medicine.disease Survival Analysis 030228 respiratory system Surgery Kawasaki disease business |
| Zdroj: | The Annals of Thoracic Surgery. 108:799-805 |
| ISSN: | 0003-4975 |
| Popis: | Background Although coronary artery bypass grafting (CABG) is the preferred choice for advanced Kawasaki disease (KD)-associated coronary artery disease, graft design such as number of grafts or type of conduits has not been fully established. We reviewed a series of patients who underwent single or multiple CABG for coronary artery disease of KD sequelae to investigate the optimum revascularization strategy. Methods We enrolled a consecutive series of 102 CABG surgeries in 92 patients during the last 36 years. Mean patient age at CABG was 14.9 ± 10.4 years. Internal thoracic artery, radial artery, and gastroepiploic artery were used in 100 (98%), 18 (15%), and 4 (4%) cases, respectively. Patients were divided into 2 groups by single (n = 53) or multiple (n = 49) CABG. Results Actuarial survival was 93% in single CABG and 91% in multiple CABG at 30 years (P = .71). There was no in-hospital mortality, but 6 deaths occurred long term, with no significant difference between the groups. Freedom from cardiac events was 45.2% in single CABG and 68.5% in multiple CABG at 25 years (P = .228), and reintervention to the left anterior descending (LAD) artery territory was the most common event. Graft patency of the internal thoracic artery–LAD artery graft was 81% in single CABG and 85% in multiple CABG at 25 years. Patency of the radial artery in the non-LAD artery territories was significantly greater than that of the saphenous vein graft at 10 years (91% vs 46%, P = .013). Conclusions Multiple CABG using arterial conduits is feasible, safe, and therapeutically effective long term for patients with advanced KD-associated coronary artery disease. |
| Databáze: | OpenAIRE |
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