Abstract 2451: Long-Term Follow-Up Results of Catheter Intervention and Coronary Artery Bypass Grafting for Stenotic Lesions after Kawasaki Disease -Multi-Center Collaborative Study-
[Purpose] To clarify the long-term results of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) for stenotic lesions in Kawasaki disease (KD).
[Methods] Patients who developed coronary stenotic lesions caused by KD and treated with PCI or CABG were investigated. Re-stenosis or obstruction was diagnosed when the stenosis was ≥ 75% by coronary angiography or ischemic change was observed by myocardial perfusion imaging.
[Results] A total of 84 patients (69 males and 15 females) were reported. Median age at PCI and CABG was 14.5 years and 10.0 years. Median follow-up period in PCI and CABG group was 6.3 years and 5.2 years. The types of PCI included percutaneous balloon angioplasty (n=22), stent implantation (n=7), percutaneous transluminal coronary rotational ablation (PTCRA) (n=22), and combination of PTCRA with stent implantation (n=4). Grafts used were gastroepiploic artery (n=15), internal thoracic artery (n=52), and saphenous vein (n=3). Of 55 stenotic lesions in PCI group, 52 (95%) were successfully dilated by PCI. Immediate complications in PCI group included neo-aneurysm in 5 patients, transient bradycardia in 3, and atrial fibrillation in 1, and those in CABG group included mitral regurgitation in 1, and cardiac tamponade in 1. Cumulative patency rates in PCI and CABG groups were similar (Figure⇓; p=0.3). Treatments for re-stenosis in PCI group were re-PCI in 3 patients, CABG in 6, and heart transplantation in 1. No patient died in PCI group, but 2 patients died in CABG group (sudden death in 1, heart failure in 1).
[Conclusions] Long-term results of PCI and CABG for KD are favorable. Selective indication for each procedure must be established.