Abstract 15080: Long-Term Follow-Up of Percutaneous Coronary Intervention for Kawasaki Disease Patients
Background: Number of Kawasaki disease (KD) patients in Japan has been increasing since the disease was found in 1967. Coronary aneurysm and stenosis in chronic phase of KD cause ischemic heart disease (IHD) in childhood. Percutaneous coronary intervention (PCI) with balloon, stent, or rotablator was performed in some cases. Though patients who have undergone PCI in childhood are grown up to adults, the long-term outcome after PCI for KD was unknown. Aim: To reveal the long-term outcome of PCI for KD patients.
Method: Consecutive 39 patients (44 lesions) who undergone the first successful elective PCI for IHD after KD since Aug. 1994 to May. 2012 were followed up. Information was obtained from medical record, telephone interview, or letters to primary care doctors and other hospital doctors. Researched items were death, myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), coronary artery bypass graft (CABG) after index PCI, and major adverse cardiac event (MACE, composite of cardiac death, MI and sudden cardiopulmonary arrest).
Results: 31 patients (79.4%) were male and the mean age when they underwent PCI was 16.2 years old (ranged 4 to 34). Three patients had undergone previous CABG by the time of index PCI. Rotablator was used in 37 lesions (84.1%, mean final burr size 2.15mm), balloon angioplasty was performed in 44 (100%), and bare-metal stent was implanted in four (9.1%). Median value of follow-up duration was 10.5 years. TLR free survival rate was 62.3%, 62.3%, 53.4% at 5, 10, 15 years respectively. TLR was reduced after three years. Two patients underwent CABG after index PCI. One patient fell into cardiopulmonary arrest during playing soccer and was rescued and recovered after mild hypothermia therapy.
Conclusion: Long-term outcome after PCI for KD patients is acceptable though some of them need revascularization within three years. However, we need to pay attention to cardiac event even in small number of patients.
- © 2012 by American Heart Association, Inc.