Surgical treatment of giant coronary artery aneurysm secondary to Kawasaki disease
| Autor: | Heping Zhou, Yunya Wang, Rong Zhao, Guocheng Sun, Dinghua Yi, Chunhu Gu, Shanhong Fan |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Mucocutaneous Lymph Node Syndrome Young Adult Aneurysm Intensive care Internal medicine medicine Humans cardiovascular diseases Myocardial infarction Child Coronary artery aneurysm Ejection fraction business.industry Coronary Aneurysm Middle Aged medicine.disease Surgery Coronary arteries medicine.anatomical_structure Treatment Outcome Heart failure Child Preschool cardiovascular system Cardiology Kawasaki disease Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | The heart surgery forum. 12(4) |
| ISSN: | 1522-6662 |
| Popis: | Aim: To investigate the clinical features and surgical management of giant coronary artery aneurysm during end-stage Kawasaki disease.Methods: From May 2006 to October 2007, 5 patients, 2 to 57 years old, presented with giant coronary artery aneurysm and underwent surgical correction. The coronary aneurysm diameters were 1.5 to 2.5 cm. The coronary aneurysm lesion sites included the right main coronary artery in 1 case, the left main coronary artery in 2 cases, and both the left and right coronary arteries in 2 cases. Preoperative electrocardiogram revealed altered S-T segments in 5 cases and reduced ejection fraction values in 3 cases, resulting in 1 emergency admission for congestive heart failure. Surgical treatments included thromboendarterectomy, thrombectomy, and aneurysmal reconstruction under the orthophoria of extracorporeal circulation.Results: There were no operative deaths. All patients recovered and received dopamine 2 to 4 ?g/min per kg and nitroglycerine 0.3 to 0.5 ?g/min per kg. Time spent by patients in intensive care was uneventful. Following surgery, 4 patients showed ischemic improvement of the S-T segment on electrocardiograms, and 4 patients presented with increased ejection fraction, according to cardiac ultrasound inspection. The improvement of ejection fraction value was not significant in only 1 case.Conclusion: Surgery is necessary for stage-3 Kawasaki disease patients that have giant coronary artery aneurysm complications. Surgical treatment includes thromboendarterectomy, thrombus clearing, aneurysmal reconstruction, and coronary artery bypass grafting, followed by postoperative anticoagulation and immunotherapy. Myocardial ischemia and cardiac function can be greatly improved through surgery. |
| Databáze: | OpenAIRE |
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