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(Circulation. 2004;110:II-61 – II-66.)
© 2004 American Heart Association, Inc.

Surgery for Coronary Artery Disease

National Survey of Coronary Artery Bypass Grafting for Coronary Stenosis Caused by Kawasaki Disease in Japan

Etsuko Tsuda, MD; Soichiro Kitamura, MD; The Cooperative Study Group of Japan

From the Department of Pediatrics and Department of Cardiovascular Surgery, National Cardiovascular Center, Osaka, Japan.

Correspondence to Etsuko Tsuda, MD, Department of Pediatrics, National Cardiovascular Center, 5-7-1 Fujishirodai, Suita-shi, Osaka, 565-8565, Japan. E-mail etsuda{at}hsp.ncvc.go.jp

Background— We surveyed the national experience of coronary artery bypass grafting (CABG) for coronary sequelae of Kawasaki disease (kDa) in 2002.

Methods and Results— A questionnaire was returned from 323/552 (59%) institutions. Two hundred forty-four patients (188 male 56 female) since 1975 were identified. The mean number of grafts was 1.8 and the age at operation ranged from 1 to 44 years (median 11 years). The interval from the onset of kDa to operation ranged from 1 month to 42 years (median 8 years), whereas the follow-up period was from 7 days to 25 years (median 5 years). Previous myocardial infarction was found in 70 patients (28%). When the age at operation was older than 12 years, patency rates for internal thoracic artery grafts (ITA) at 1, 5, and 15 years were 95%, 91%, and 91%, respectively (n=156). When the age at operation was younger than 12 years, the corresponding values were significantly lower, with 1, 5, and 15 years being 93%, 73%, and 65%, respectively (n=146) (P<0.05). Reoperation was performed in 14 patients (6%). Death occurred in 15 patients (6%). Nine of the 14 late deaths were sudden. Six of 8 patients with a left ventricular ejection fraction (LVEF) <40% died.

Conclusion— The results of ITA in those aged 12 years or older were favorable. LVEF influenced prognosis.

Key Words: Kawasaki disease • coronary artery disease • coronary artery bypass grafting

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