LONG-TERM FOLLOW-UP RESULTS OF PERCUTANEOUS CATHETER INTERVENTION FOR CORONARY ARTERY LESIONS AFTER KAWASAKI DISEASE: MULTICENTER COLLABORATIVE STUDY
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
- Copyright © 2008 by the American Academy of Pediatrics