Long-Term Prognosis for Patients with Kawasaki Disease Complicated by Large Coronary Aneurysm (diameter ≥6 mm).
- Author:
Ji Seok BANG
1
;
Gi Beom KIM
;
Bo Sang KWON
;
Mi Kyung SONG
;
Hyo Soon AN
;
Young Whan SONG
;
Eun Jung BAE
;
Chung Il NOH
Author Information
- Publication Type:Original Article
- Keywords: Mucocutaneous lymph node syndrome; Coronary aneurysm; Myocardial infarction; Prognosis
- MeSH: Age of Onset; Aneurysm; Catheters; Coronary Aneurysm*; Coronary Stenosis; Coronary Vessels; Follow-Up Studies; Humans; Male; Medical Records; Mucocutaneous Lymph Node Syndrome*; Myocardial Infarction; Myocardial Ischemia; Prognosis*; Retrospective Studies
- From:Korean Circulation Journal 2017;47(4):516-522
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND AND OBJECTIVES: Some patients with Kawasaki disease (KD) develop large coronary aneurysms and subsequent coronary stenosis or obstruction, leading to ischemic heart disease. This study examined the long-term outcomes of patients with KD complicated by large coronary aneurysms. SUBJECTS AND METHODS: The medical records of 71 patients (53 men and 18 women) diagnosed with large coronary aneurysms (diameter ≥6 mm) between December 1986 and December 2013 were retrospectively reviewed from our institutional database. RESULTS: The mean age at onset was 4.6±3.3 years, and the mean follow-up duration was 12.5±6.9 years. Maximum coronary artery internal diameter ranged from 6.1 to 25 mm. Giant coronary aneurysms occurred in 48 patients and coronary aneurysms 6-8 mm in diameter developed in 23 patients. Coronary stenosis and/or complete occlusion occurred in 30 patients (42.3%). Catheter and/or surgical interventions (mean: 1.5 interventions, range: 1-5 interventions) were performed in 20 patients (28.2%), 9 months to 18 years after KD onset, resulting in 33.7% cumulative coronary intervention rates at 20 years after onset. There were no differences in cumulative coronary intervention rates between two coronary aneurysm groups (6-8 mm vs. ≥8 mm). Myocardial infarction occurred in 7 patients with a giant aneurysm and there was one death. CONCLUSIONS: Long-term survival of patients with KD complicated by large coronary aneurysm was good even though 28.2% of patients underwent multiple catheter or surgical interventions. Careful follow-up is also necessary in KD patients with coronary aneurysms 6-8 mm in diameter, such as those with giant aneurysms.
