Published online January 2, 2008
PEDIATRICS Vol. 121 Supplement January 2008, pp. S94 (doi:10.1542/peds.2007-2022N)
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ALLERGOLOGY


LONG-TERM FOLLOW-UP RESULTS OF PERCUTANEOUS CATHETER INTERVENTION FOR CORONARY ARTERY LESIONS AFTER KAWASAKI DISEASE: MULTICENTER COLLABORATIVE STUDY

Masahiro Ishiia, Hiromi Mutab, Yayoi Nakahataa, Syouhei Ogataa, Sumito Kimuraa, Mamoru Ayusawac, Motofumi Iemurab and Syunichi Ogawad

a Kitasato University, Tokyo, Japan
b Kurume University, Fukuoka-ken, Japan
c Nihon University, Tokyo, Japan
d Nihon Medical University, Tokyo, Japan

ABSTRACT

INTRODUCTION: The long-term prognosis in patients with Kawasaki disease (KD) after percutaneous coronary intervention (PCI) remains unclear.

OBJECTIVE: We sought to clarify the long-term results of PCI for KD.

METHODS: Patients who developed coronary stenotic lesions caused by KD and were treated with PCI were investigated. Restenosis or obstruction was diagnosed when the stenosis was ≥75% according to coronary angiography or ischemic change was observed by myocardial perfusion imaging.

RESULTS: A total of 55 stenotic lesions were reported in 49 patients in 5 institutions. The types of PCI included percutaneous transluminal coronary angioplasty (n = 22), stent implantation (n = 7), percutaneous transluminal coronary rotational ablation (PTCRA) (n = 22), and combination of PTCRA with stent implantation (n = 4). Median age at PCI was 14.5 years, and the median follow-up period in the PCI group was 6.3 years. of 55 stenotic lesions in the PCI group, 52 (95%) were dilated successfully by PCI. Immediate complications in the PCI group included neoaneurysm in 5 patients, transient bradycardia in 3 patients, and atrial fibrillation in 1 patient. Treatment for restenosis in the PCI group included re-PCI in 3 patients, coronary artery bypass grafting in 6 patients, and heart transplantation in 1 patient. No patient in the PCI group died. There was no difference in effectiveness among the 3 PCI devices (percutaneous transluminal coronary angioplasty versus stent implantation versus PTCRA: log-rank test, P = .3).

CONCLUSIONS: PCI for KD can be accomplished and can be effective in the long-term.

Submitted by Masahiro Ishii