Indication of aortocoronary by-pass for coronary arterial obstruction due to Kawasaki disease.

Abstract:

:Six patients with coronary arterial lesions due to Kawasaki disease underwent aortocoronary by-pass grafting at our institute. Before surgery, all of them had been closely monitored for some years by means of selective coronary arteriography, thallium myocardial imaging, electrocardiography (treadmill and/or Holter), and two-dimensional echo cardiography. Based on this experience, we propose the following guidelines as an indication for aortocoronary by-pass in such patients. First, the following three conditions should be satisfied: 1) The progress of coronary arterial lesions has been documented by serial selective coronary arteriography; 2) redistribution to the perfusion defect has been detected on the delayed image in myocardial imaging; 3) no coronary arterial lesions distal to the graft site have been detected by coronary angiography. When these three conditions are satisfied, at least one of the following conditions must apply: 1) Localized stenosis in the left main trunk has progressed to critical stenosis; 2) there is occlusion of two or more vessels; 3) collateral vessels connecting to the peripheral portion of an occluded coronary artery arise from the peripheral part of a vessel with progressive localized stenosis; 4) progressive localized stenosis or critical stenosis has developed in the left anterior descending artery, in addition to significant stenosis in the right coronary artery.

journal_name

Heart Vessels

journal_title

Heart and vessels

authors

Suzuki A,Kamiya T,Ono Y,Takahashi N,Naito Y,Kou Y

doi

10.1007/BF02066356

subject

Has Abstract

pub_date

1985-05-01 00:00:00

pages

94-100

issue

2

eissn

0910-8327

issn

1615-2573

journal_volume

1

pub_type

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