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Percutaneous transluminal coronary angioplasty for anastomotic stenosis after coronary arterial bypass grafting in Kawasaki disease

Published online by Cambridge University Press:  24 May 2005

Aya Miyazaki ,
Etsuko Tsuda ,
Shunichi Miyazaki ,
Soichiro Kitamura ,
Hideshi Tomita  and
Shigeyuki Echigo
Aya Miyazaki
Affiliation:
Department of Pediatrics, National Cardiovascular Center, Suita, Osaka, Japan
Etsuko Tsuda
Affiliation:
Department of Pediatrics, National Cardiovascular Center, Suita, Osaka, Japan
Shunichi Miyazaki
Affiliation:
Department of Internal Medicine, National Cardiovascular Center, Suita, Osaka, Japan
Soichiro Kitamura
Affiliation:
Department of Cardiovascular Surgery, National Cardiovascular Center, Suita, Osaka, Japan
Hideshi Tomita
Affiliation:
Department of Pediatrics, National Cardiovascular Center, Suita, Osaka, Japan
Shigeyuki Echigo
Affiliation:
Department of Pediatrics, National Cardiovascular Center, Suita, Osaka, Japan
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Abstract

Objectives: We evaluated the efficacy of percutaneous transluminal coronary angioplasty for anastomotic stenosis after coronary arterial bypass grafting using the internal thoracic artery in patients with coronary arterial lesions due to Kawasaki disease. Subjects and Methods: From July 1997 to April 2000, four boys and one girl underwent percutaneous transluminal coronary angioplasty for 6 anastomotic lesions following coronary arterial bypass grafting using the left or right internal thoracic artery. Progressive severe stenosis of the grafts in the follow-up angiograms after grafting, and evidence of ischemia, were regarded as indications for percutaneous transluminal coronary angioplasty. Age at coronary angioplasty ranged from 4.2 to 16.7 years, with a median of 6.9 years, while the interval from operation ranged from 0.3 to 3.0 years, with a median of 1.1 years. The diameter of the balloon catheter employed varied from 1.5 to 2.5 mm, and the pressure of inflation ranged from 8 to 16 atmospheres. Results: The degree of stenosis decreased from 63 to 99%, with a median of 88%, to 0 to 40%, with a median of 17% immediately after angioplasty. A follow-up angiogram either 3 months or 1 year later revealed no restenosis in any patient. Conclusion: Percutaneous transluminal coronary angioplasty is a feasible and useful procedure for treating anastomotic stenosis following coronary arterial bypass grafting using the internal thoracic artery in patients with coronary arterial lesions due to Kawasaki disease.

Keywords

Anastomotic stenosispaediatric cardiac surgeryinterventional catheterization
Type
Original Article
Information
Cardiology in the Young , Volume 13 , Issue 3 , June 2003 , pp. 284 - 289
Copyright
© 2003 Cambridge University Press

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References

Dimas A, Arora R, Whitlow P, et al. Percutaneous transluminal angioplasty involving internal mammary artery grafts. Am Heart J 1991; 122: 423–429.Google Scholar
Shimshak T, Giorgi L, Johnson W, et al. Application of percutaneous transluminal coronary angioplasty to the internal mammary artery graft. J Am Coll Cardiol 1988; 12: 1205–1214.Google Scholar
Smith S, Dove J, Jacobs A, et al. ACC/AHA guidelines for percutaneous coronary intervention (revision of the 1993 PTCA guidelines) – executive summary. Circulation 2001; 103: 3019–3041.Google Scholar
Suwaidi J, Velianou J, Berger P, et al. Primary percutaneous coronary interventions in patients with acute myocardial infarction and prior coronary artery bypass grafting. Am Heart J 2001; 142: 452–459.Google Scholar
Kawata T, Hasegawa J, Yoshida Y, Yoshikawa Y, Kawachi K, Kitamura S. Percutaneous transluminal coronary angioplasty of the left internal thoracic artery graft: a case report in a child. Cathet Cardiovasc Diagn 1994; 32: 340–342.Google Scholar
Akagi T, Ogawa S, Ino T, et al. Catheter interventional treatment in Kawasaki disease: A report from the Japanese pediatric interventional cardiology investigation group. J Pediatr 2000; 137: 181–186.Google Scholar
Ino T, Akimoto K, Ohkubo M, et al. Application of percutaneous transluminal coronary angioplasty to coronary arterial stenosis in Kawasaki disease. Circulation 1996; 93: 1709–1715.Google Scholar
Kuramochi Y, Ohkubo T, Takechi N, Ogawa S. Feasibility of percutaneous transluminal coronary angioplasty to patients with Kawasaki disease as early management strategy. Pediatr Cardiol 2001; 22: 183–188.Google Scholar
Ogawa S, Fukazawa R, Ohkubo T, et al. Silent myocardial ischemia in Kawasaki disease: evaluation of percutaneous transluminal coronary angioplasty by dobutamine stress testing. Circulation 1997; 96: 3384–3389.Google Scholar
Sugimura T, Yokoi H, Sato N, et al. Interventional treatment for children with severe coronary artery stenosis with calcification after long-term Kawasaki disease. Circulation 1997; 96: 3928–3933.Google Scholar
Tsuda E, Ono Y, Tsukano S, Arakaki Y, Kamiya T, Yagihara T. Long-term results of coronary artery bypass grafting for coronary arterial lesions due to Kawasaki disease: Cases with new appearance of localized stenosis after the surgery. In: Imai Y, Momma K (eds). Proceedings of the second world congress of pediatric cardiology and cardiac surgery. Futura Publishing Co. Inc., Armonk, New York, 1997, pp 1117–1119.
Kitamura S, Kameda Y, Seki T, et al. Long-term outcome of myocardial revascularization in patients with Kawasaki coronary artery disease. A multicenter cooperative study. J Thorac Cardiovasc Surg 1994; 107: 663–673.Google Scholar
Yoshikawa Y, Yagihara T, Kameda Y, et al. Result of surgical treatments in patients with coronary-artery obstructive disease after Kawasaki disease. Eur J Cardio-thorac Surg 2000; 17: 515–519.Google Scholar
Kato H, Ichinose E, Yoshioka F, et al. Fate of coronary aneurysms in Kawasaki disease: serial coronary angiography and long term follow up study. Am J Cardiol 1982; 49: 1758–1766.Google Scholar
Kato H, Koike S, Yamamoto M, Ito Y, Yano E. Coronary artery aneurysms in infants and young children with acute febrile mucocutaneous lymph node syndrome. J Pediatr 1975; 86: 892–898.Google Scholar
Kato H, Sugimura T, Akagi T, et al. Long-term consequences of Kawasaki disease: a 10- to 21-year follow up study of 594 patients. Circulation 1996; 94: 1379–1385.Google Scholar
Kameda Y, Kitamura S, Taniguchi S, et al. Differences in adaptation to growth of children between internal thoracic artery and saphenous vein coronary bypass grafts. J Cardiovasc Surg 2001; 42: 9–16.Google Scholar