Abstract 18578: Long-term Outcome of After Percutaneous Coronary Intervension for Ischemic Heart Disease Caused by Kawasaki Disease
Introduction: The most important complication of Kawasaki disease (KD) is the coronary aneurysms and stenosis. Various types of percutaneous coronary intervention (PCI) have been successfully offered to alleviate ischemic coronary stenosis. However, little data is available concerning the long term outcome of these PCI.
Hypothesis: Long term outcome of PCI for KD is not great as expected and requires additional revascularization therapy.
Methods: Subjects were 22 patients (19 male and 3 female) with a history of KD who developed ischemic heart disease as a result of coronary aneurysms and were treated by PCI since 1994. Patients were evaluated regularly with CT or coronary angiography every one to five years. From medical chart, patients’ information concerning demographics, history of catheter and surgical interventions, and final outcome were collected. Based on these data, we calculated re-stenosis free rate using Kaplan-Meier’s analysis.
Results: Subject’s age at onset was 2.3 ± 2.4 years old and median observational period was 9.9 years (range 0.2-21.8 years). PCI was applied on #6 (n = 9), #1 (n = 8), #2 (n = 4), and #5 (n = 1) of coronary arteries. PCI included percutaneous transluminal coronary rotational ablation (PTCRA) (n=16), plain old balloon angioplasty (POBA) (n=3), PTCRA+coronary artery stenting (n=2), and coronary artery stenting(n=1). In the follow-up period, 10 (45%) patients showed re-stenosis. Of 10 patients, 8 patients underwent additional PTCRA (n=5), POBA (1), stent placement (1), and coronary bypass graft surgery (CABG)(1). In the remaining 2 patients that showed total occlusion of target vessel (#1), 1 patient has been scheduled for PCI and the other treated medically because of sufficient collateral communications. Re-stenosis free year was 0.1, 0.2, 0.3, 0.3, 0.6, 2.6, 2.9, 10.2, 14.6, 21.7 years, giving re-stenosis free rate of 68% at 5 years after PCI. Only 1 patient who previously underwent CABG and had stenosis on #5 died at 2nd PTCRA because of acute myocardial infarction and the remaining 21 patients survived with a median age of 24.8 years old, giving 5years survival rate of 95%.
Conclusions: Long-term outcome of PCI for KD can be acceptable, but meticulous management looking for re-stenosis soon after the procedure is mandatory.
Author Disclosures: Y. Koteda: None. K. Suda: None. T. Ueno: None. S. Kishimoto: None. Y. Kagiyama: None. Y. Yamashita: None.
- © 2016 by American Heart Association, Inc.