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J Thorac Cardiovasc Surg 2009;137:1554-1555
© 2009 The American Association for Thoracic Surgery

Brief Communication

Off-pump revascularization with the use of both internal thoracic arteries in a 3-year-old child with Kawasaki syndrome

Monika Kowalczyk, MDa,*, Zbigniew Juraszynski, MD, PhDb, Piotr Burczynski, MD, PhDc, Grazyna Brzezinska-Rajszys, MD, PhDd, Wanda Kawalec, MD, PhDa

b Department of Cardiosurgery, Institute of Cardiology, The Children's Memorial Health Institute, Warsaw, Poland
a Department of Cardiology, The Children's Memorial Health Institute, Warsaw, Poland
c Department of Cardiosurgery, The Children's Memorial Health Institute, Warsaw, Poland
d Catheterization Laboratory, The Children's Memorial Health Institute, Warsaw, Poland

Received for publication February 24, 2008; revisions received May 2, 2008; accepted for publication July 5, 2008.

* Address for reprints: Monika Kowalczyk, MD, the Department of Pediatric Cardiology, the Children's Memorial Health Institute, Aleja Dzieci Polskich 20, Warsaw 04-730, Poland. (Email: monkowal@poczta.onet.pl).

The first 20% of the full text of this article appears below.

Kawasaki syndrome is a generalized vasculitis of unknown origin. Giant coronary artery aneurysms develop in 0.27% of cases.1Go We present the case of a 3-year-old boy with Kawasaki disease with giant coronary artery aneurysms after myocardial infarction. The patient underwent successful revascularization with both internal thoracic arteries (ITAs).

Clinical Summary

A 31/2-old-boy had a history of acute Kawasaki disease in September 2003 at the age of 4 months, with giant coronary artery aneurysms (Figures 1 and 2 Go) after standard treatment in the acute stage. During 32 months of follow-up he received treatment with an oral anticoagulant and aspirin, remaining in good general condition with a normal ejection fraction (EF) on transthoracic echocardiography (TTE).


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  		Figure 1. Frontal projection of selective LCA injection showing the large aneurysm involving left main and proximal aspects of LAD and circumflex coronary arteries—acute stage.

 

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  		Figure 2. Right anterior oblique projection of selective LCA injection showing occlusion of the proximal segment of LAD—before the operation.

 
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