Off-pump mammary-coronary bypass of anterior interventricular artery in 5.5-month infant with Kawasaki disease complicated with acute myocardial infarction

Abstract

Kawasaki disease (KD) is a rare disease and its etiology is unknown. The majority of patients with KD are children under the age of 5. The injury of the coronary arteries (CA) in the acute period of the KD is accompanied by the formation of giant aneurysms of the proximal coronary arteries. In 16 % of patients, the course of KD may be complicated by acute myocardial infarction (AMI). Mortality with the first AMI is 22 %, with a repeated one - 66 %, and with the third - 87 %. The average period between the debuting of KD and the operation is 8 years. There is no data about the operation in the early stages of KD and with AMI. There are very few observations of successful operations of the left anterior descending artery (LAD) with using of to left anterior descending (LIMA), in children with KD since the age of two were published. This report presents the clinical case of the successful off-pump coronary artery bypass of LAD with using LIMA in an infant aged 5.5 months with KD. The operation was performed in a less than 1 month from the onset of the disease and 12 days by the AMI. After 7.5 months after the operation, the restoration of blood flow in the LAD and the termination of competitive blood flow through the graft are noted. In 8 years after the operation, the child develops according to age.

Keywords

• kawasaki disease
• nepionic age
• off-pump mammary-coronary bypass
• acute myocardial infarction