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Erschienen in: General Thoracic and Cardiovascular Surgery 3/2018

06.12.2017 | Current Topics Review Article

Review: surgical treatment of giant coronary aneurysms in pediatric patients with Kawasaki disease

verfasst von: Masami Ochi

Erschienen in: General Thoracic and Cardiovascular Surgery | Ausgabe 3/2018

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Abstract

In Kawasaki disease (KD), giant coronary aneurysms in the proximal segments of the coronary arteries have long been among the serious complications associated with acute myocardial infarction. To treat myocardial ischemia in children, Kitamura et al. first performed coronary artery bypass grafting in a pediatric patient using an autologous saphenous vein. In the early 1980s, they began to use the internal thoracic artery (ITA) as a bypass graft to the left anterior descending artery, which later was proven to improve long-term life expectancy with its favorable long-term patency, as well as growth potential. Thus, the excellent characteristics of the ITA have come to be widely known among pediatric cardiac surgeons, and a growing number of coronary bypass surgery procedures using the ITA are now being performed worldwide. Although a longer follow-up with more patients is necessary, downsizing reconstructive procedure may be a treatment of choice for giant aneurysms of non-LAD territories to improve coronary circulation. The efficacy of surgical treatment for giant coronary aneurysms in pediatric patients with Kawasaki disease is now well established. Pediatric coronary artery bypass grafting using the ITA, either single or bilateral, can be safe not only for patients with Kawasaki coronary disease but also for infants with congenital coronary lesions.
Literatur
1.
Zurück zum Zitat Kawasaki T, Kosakai F, Okawa S, Shigematsu I, Yanagawa H. A new infantile acute febrile mucocutaneous lymph node syndrome (MLNS) prevailing in Japan. Pediatrics. 1974;54:271–6.PubMed Kawasaki T, Kosakai F, Okawa S, Shigematsu I, Yanagawa H. A new infantile acute febrile mucocutaneous lymph node syndrome (MLNS) prevailing in Japan. Pediatrics. 1974;54:271–6.PubMed
2.
Zurück zum Zitat Fujiwara H, Hamashima Y. Pathology of the heart in Kawasaki disease. Pediatrics. 1978;61:100–7.PubMed Fujiwara H, Hamashima Y. Pathology of the heart in Kawasaki disease. Pediatrics. 1978;61:100–7.PubMed
3.
Zurück zum Zitat Landing BH, Larson E. Pathological features of Kawasaki disease (mucocutaneous lymph node syndrome). Am J Cardiovasc Pathol. 1987;1:218–29.PubMed Landing BH, Larson E. Pathological features of Kawasaki disease (mucocutaneous lymph node syndrome). Am J Cardiovasc Pathol. 1987;1:218–29.PubMed
4.
Zurück zum Zitat Naoe S, Takahashi K, Masuda H, Tanaka N. Kawasaki disease. With parcicular emphasis on arterial lesions. Acta Pathol Jpn. 1991;41:785–97.PubMed Naoe S, Takahashi K, Masuda H, Tanaka N. Kawasaki disease. With parcicular emphasis on arterial lesions. Acta Pathol Jpn. 1991;41:785–97.PubMed
5.
Zurück zum Zitat Amano S, Hazama F, Hamashima Y. Pathology of Kawasaki disease: II. Distribution and incidence of the vascular lesions. Jpn Circ J. 1979;43:741–8.CrossRefPubMed Amano S, Hazama F, Hamashima Y. Pathology of Kawasaki disease: II. Distribution and incidence of the vascular lesions. Jpn Circ J. 1979;43:741–8.CrossRefPubMed
6.
Zurück zum Zitat Ohkubo T, Fukazawa R, Ikegami E, Ogawa S. Reduced shear stress and disturbed flow may lead to coronary aneurysm and thrombus formations. Pediat Int. 2007;49:1–7.CrossRef Ohkubo T, Fukazawa R, Ikegami E, Ogawa S. Reduced shear stress and disturbed flow may lead to coronary aneurysm and thrombus formations. Pediat Int. 2007;49:1–7.CrossRef
7.
Zurück zum Zitat Kuramochi Y, Ohkubo T, Takechi N, Fukumi D, Uchikoba Y, Ogawa S. Hemodynamic factors of thrombus formation in coronary aneurysms associated with Kawasaki disease. Pediatr Int. 2000;42:470–5.CrossRefPubMed Kuramochi Y, Ohkubo T, Takechi N, Fukumi D, Uchikoba Y, Ogawa S. Hemodynamic factors of thrombus formation in coronary aneurysms associated with Kawasaki disease. Pediatr Int. 2000;42:470–5.CrossRefPubMed
8.
Zurück zum Zitat Hamaoka K, Onouchi S. Effects of coronary artery aneurysms on intracoronary flow velocity dynamics in Kawasaki disease. Am J Cardiol. 1996;77:873–5.CrossRefPubMed Hamaoka K, Onouchi S. Effects of coronary artery aneurysms on intracoronary flow velocity dynamics in Kawasaki disease. Am J Cardiol. 1996;77:873–5.CrossRefPubMed
9.
Zurück zum Zitat Subcommittee of cardiovascular sequelae SoST, Kawasaki Disease Research Committee. Guidelines for treatment and management of cardiovascular sequelae in Kawasaki disease. Heart Vessels. 1987; 3:50–4.CrossRef Subcommittee of cardiovascular sequelae SoST, Kawasaki Disease Research Committee. Guidelines for treatment and management of cardiovascular sequelae in Kawasaki disease. Heart Vessels. 1987; 3:50–4.CrossRef
10.
Zurück zum Zitat Kato H, Sugimura T, Akagi T, Sato N, Hashino K, et al. Long-term consequences of Kawasaki disease. A 10- to 21-year follow-up study of 594 patients. Circulation. 1996;94(6):1379–85.CrossRefPubMed Kato H, Sugimura T, Akagi T, Sato N, Hashino K, et al. Long-term consequences of Kawasaki disease. A 10- to 21-year follow-up study of 594 patients. Circulation. 1996;94(6):1379–85.CrossRefPubMed
11.
Zurück zum Zitat JCS Joint Working Group. Guidelines for diagnosis and management of cardiovascular sequelae in Kawasaki disease (JCS 2013). Circ J Jpn Circu Soc, 2014;78:2521–2562. JCS Joint Working Group. Guidelines for diagnosis and management of cardiovascular sequelae in Kawasaki disease (JCS 2013). Circ J Jpn Circu Soc, 2014;78:2521–2562.
12.
Zurück zum Zitat Nakano H, Ueda K, Saito A, Nojima K. Repeated quantitative angiograms in coronary arterial aneurysm in Kawasaki disease. Am J Cardiol. 1985;56:846–51.CrossRefPubMed Nakano H, Ueda K, Saito A, Nojima K. Repeated quantitative angiograms in coronary arterial aneurysm in Kawasaki disease. Am J Cardiol. 1985;56:846–51.CrossRefPubMed
13.
Zurück zum Zitat Suzuki A, Kamiya T, Arakaki Y, Kinoshita Y, Kimura K. Fate of coronary arterial aneurysms in Kawasaki disease. Am J Cardiol. 1994;74:822–4.CrossRefPubMed Suzuki A, Kamiya T, Arakaki Y, Kinoshita Y, Kimura K. Fate of coronary arterial aneurysms in Kawasaki disease. Am J Cardiol. 1994;74:822–4.CrossRefPubMed
14.
Zurück zum Zitat Kato H, Ichinose E, Kawasaki T. Myocardial infarction in Kawasaki disease: clinical analyses in 195 cases. J Pediatr. 1986;108:923–7.CrossRefPubMed Kato H, Ichinose E, Kawasaki T. Myocardial infarction in Kawasaki disease: clinical analyses in 195 cases. J Pediatr. 1986;108:923–7.CrossRefPubMed
15.
Zurück zum Zitat Suda K, Kudo Y, Higaki T, Nomura Y, Miura M, et al. Multicenter and retrospective case study of warfarin and aspirin combination therapy in patients with giant coronary aneurysms caused by Kawasaki disease. Circ J. 2009;73:1319–23.CrossRefPubMed Suda K, Kudo Y, Higaki T, Nomura Y, Miura M, et al. Multicenter and retrospective case study of warfarin and aspirin combination therapy in patients with giant coronary aneurysms caused by Kawasaki disease. Circ J. 2009;73:1319–23.CrossRefPubMed
16.
Zurück zum Zitat Sugahara Y, Ishii M, Muta H, Iemura M, Matsuishi T, Kato H. Warfarin therapy for giant aneurysm prevents myocardial infarction in Kawasaki disease. Pediatr Cardiol. 2008;29:398–401.CrossRefPubMed Sugahara Y, Ishii M, Muta H, Iemura M, Matsuishi T, Kato H. Warfarin therapy for giant aneurysm prevents myocardial infarction in Kawasaki disease. Pediatr Cardiol. 2008;29:398–401.CrossRefPubMed
17.
Zurück zum Zitat Onouchi Z, Hamaoka K, Sakata K, Ozawa S, Shiraishi I, et al. Long-term changes in coronary artery aneurysms in patients with Kawasaki disease: comparison of therapeutic regimens. Circ J. 2005;69:265–72CrossRefPubMed Onouchi Z, Hamaoka K, Sakata K, Ozawa S, Shiraishi I, et al. Long-term changes in coronary artery aneurysms in patients with Kawasaki disease: comparison of therapeutic regimens. Circ J. 2005;69:265–72CrossRefPubMed
18.
Zurück zum Zitat Levy DM, Silverman ED, Massicotte MP, McCrindle BW, Yeung RS. Longterm outcomes in patients with giant aneurysms secondary to Kawasaki disease. J Rheumatol. 2005;32:928–34PubMed Levy DM, Silverman ED, Massicotte MP, McCrindle BW, Yeung RS. Longterm outcomes in patients with giant aneurysms secondary to Kawasaki disease. J Rheumatol. 2005;32:928–34PubMed
19.
Zurück zum Zitat Su D, Wang K, Qin S, Pang Y. Safety and efficacy of warfarin plus aspirin combination for giant coronary aneurysm secondary to Kawasaki disease: a meta-analysis. Cardiology 2014;129:55–64CrossRefPubMed Su D, Wang K, Qin S, Pang Y. Safety and efficacy of warfarin plus aspirin combination for giant coronary aneurysm secondary to Kawasaki disease: a meta-analysis. Cardiology 2014;129:55–64CrossRefPubMed
20.
Zurück zum Zitat Newburger JW, Takahashi M, Gerber MA, Gewitz MH, Tani LY, et al. American academy of pediatrics. Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Circulation. 2004;110:2747–71CrossRefPubMed Newburger JW, Takahashi M, Gerber MA, Gewitz MH, Tani LY, et al. American academy of pediatrics. Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Circulation. 2004;110:2747–71CrossRefPubMed
21.
Zurück zum Zitat Kitamura S, Kawashima Y, Fujita T, Mori T, Oyama C. Aortocoronary bypass grafting in a child with coronary artery obstruction due to mucocutaneous lymphnode syndrome: report of a case. Circulation. 1976;53:1035–40.CrossRefPubMed Kitamura S, Kawashima Y, Fujita T, Mori T, Oyama C. Aortocoronary bypass grafting in a child with coronary artery obstruction due to mucocutaneous lymphnode syndrome: report of a case. Circulation. 1976;53:1035–40.CrossRefPubMed
22.
Zurück zum Zitat Suma K, Takeuchi Y, Shiroma K, et al. Early and late postoperative studies in coronary arterial lesions resulting from Kawasaki’s disease in children. J Thorac Cardiovasc Surg 1982;84:224–9PubMed Suma K, Takeuchi Y, Shiroma K, et al. Early and late postoperative studies in coronary arterial lesions resulting from Kawasaki’s disease in children. J Thorac Cardiovasc Surg 1982;84:224–9PubMed
23.
Zurück zum Zitat Kitamura S, Kawachi K, Harima R, Sakakibara T, Hirose H, Kasashima Y. Surgery for coronary heart disease due to mucocutaneous lymph node syndrome (Kawasaki disease). Report of 6 patients. Am J Cardiol 1983;51:444–8.CrossRefPubMed Kitamura S, Kawachi K, Harima R, Sakakibara T, Hirose H, Kasashima Y. Surgery for coronary heart disease due to mucocutaneous lymph node syndrome (Kawasaki disease). Report of 6 patients. Am J Cardiol 1983;51:444–8.CrossRefPubMed
24.
Zurück zum Zitat Kitamura S, Kawachi K, Oyama C, Miyagi Y, Morita R, Koh Y, et al. Severe Kawasaki heart disease treated with an internal mammary artery graft in pediatric patients. A first successful report. J Thorac Cardiovasc Surg. 1985;89:860–6.PubMed Kitamura S, Kawachi K, Oyama C, Miyagi Y, Morita R, Koh Y, et al. Severe Kawasaki heart disease treated with an internal mammary artery graft in pediatric patients. A first successful report. J Thorac Cardiovasc Surg. 1985;89:860–6.PubMed
25.
Zurück zum Zitat Kitamura S, Seki T, Kawachi K, Morita R, Kawata T, Mizuguchi K, et al. Excellent patency and growth potential of internal mammary artery grafts in pediatric coronary artery bypass surgery. New evidence for a “live” conduit. Circulation 1988;78(1):I 129-I 139. Kitamura S, Seki T, Kawachi K, Morita R, Kawata T, Mizuguchi K, et al. Excellent patency and growth potential of internal mammary artery grafts in pediatric coronary artery bypass surgery. New evidence for a “live” conduit. Circulation 1988;78(1):I 129-I 139.
26.
Zurück zum Zitat Kitamura S, Kawachi K, Seki T, Morita R, Nishii T, Mizuguchi K, et al. Bilateral internal mammary artery grafts for coronary artery bypass operations in children. J Thorac Cardiovasc Surg 1990;99:708–15.PubMed Kitamura S, Kawachi K, Seki T, Morita R, Nishii T, Mizuguchi K, et al. Bilateral internal mammary artery grafts for coronary artery bypass operations in children. J Thorac Cardiovasc Surg 1990;99:708–15.PubMed
27.
Zurück zum Zitat Kameda Y, Kitamura S, Taniguchi S, Kawata T, Mizuguchi K, et al. Differences in adaptation to growth of children between internal thoracic artery and saphenous vein coronary bypass grafts. J Cardiovasc Surg (Torino). 2001;42:9–16. Kameda Y, Kitamura S, Taniguchi S, Kawata T, Mizuguchi K, et al. Differences in adaptation to growth of children between internal thoracic artery and saphenous vein coronary bypass grafts. J Cardiovasc Surg (Torino). 2001;42:9–16.
28.
Zurück zum Zitat Wakisaka Y, Tsuda E, Yamada O, Yagihara T, Kitamura S. Long-term results of saphenous vein graft for coronary stenosis caused by Kawasaki disease. Cir J. 2009;73:73–7.CrossRef Wakisaka Y, Tsuda E, Yamada O, Yagihara T, Kitamura S. Long-term results of saphenous vein graft for coronary stenosis caused by Kawasaki disease. Cir J. 2009;73:73–7.CrossRef
29.
Zurück zum Zitat Kitamura S, Kameda Y, Seki T, Kawachi K, Endo M, Takeuchi Y, et al. Long-term outcome of myocardial revascularization in patients with Kawasaki coronary artery disease. A multicenter cooperative study. J Thorac Cardiovasc Surg 1994;107:663–73.PubMed Kitamura S, Kameda Y, Seki T, Kawachi K, Endo M, Takeuchi Y, et al. Long-term outcome of myocardial revascularization in patients with Kawasaki coronary artery disease. A multicenter cooperative study. J Thorac Cardiovasc Surg 1994;107:663–73.PubMed
30.
Zurück zum Zitat Yoshikawa Y, Yagihara T, Kameda Y, Taniguchi S, Tsuda E, Kawahira Y, et al. Result of surgical treatments in patients with coronary-arteial obstructive disease after Kawasaki disease. Eur J Cardiothorac Surg. 2000;17:515–9.CrossRefPubMed Yoshikawa Y, Yagihara T, Kameda Y, Taniguchi S, Tsuda E, Kawahira Y, et al. Result of surgical treatments in patients with coronary-arteial obstructive disease after Kawasaki disease. Eur J Cardiothorac Surg. 2000;17:515–9.CrossRefPubMed
31.
Zurück zum Zitat Kitamura S, Tsuda E, Kobayashi J, Yoshikawa Y, Yagihara T, et al. Twenty-five-year outcome of pediatric coronary artery bypass surgery for Kawasaki disease. Circulation. 2009;120:60–8.CrossRefPubMed Kitamura S, Tsuda E, Kobayashi J, Yoshikawa Y, Yagihara T, et al. Twenty-five-year outcome of pediatric coronary artery bypass surgery for Kawasaki disease. Circulation. 2009;120:60–8.CrossRefPubMed
32.
Zurück zum Zitat Takeuchi Y, Gomi A, Okamura Y, Mori H, Nagashima M. Coronary revascularization in a child with Kawasaki disease: use of right gastroepiploic artery. Ann Thorac Surg. 1990;50:294–6.CrossRefPubMed Takeuchi Y, Gomi A, Okamura Y, Mori H, Nagashima M. Coronary revascularization in a child with Kawasaki disease: use of right gastroepiploic artery. Ann Thorac Surg. 1990;50:294–6.CrossRefPubMed
33.
Zurück zum Zitat Mavroudis C, Backer CL, Duffy CE, Pahl E, Wax DF. Pediatric coronary artery bypass for Kawasaki congenital, post arterial switch, and iatrogenic lesions. Ann Thorac Surg. 1999; 68:506–12.CrossRefPubMed Mavroudis C, Backer CL, Duffy CE, Pahl E, Wax DF. Pediatric coronary artery bypass for Kawasaki congenital, post arterial switch, and iatrogenic lesions. Ann Thorac Surg. 1999; 68:506–12.CrossRefPubMed
34.
Zurück zum Zitat Coskun KO, Coskun ST, El Arousy M, Aminparsa M, Hornik L, et al. Pediatric patients with Kawasaki disease and a case report of Kitamura operation. ASAIO J. 2006;52:e43–e7.CrossRefPubMed Coskun KO, Coskun ST, El Arousy M, Aminparsa M, Hornik L, et al. Pediatric patients with Kawasaki disease and a case report of Kitamura operation. ASAIO J. 2006;52:e43–e7.CrossRefPubMed
35.
Zurück zum Zitat Newburger JW, Fulton DR. Coronary revascularization in patients with Kawasaki disease. J Pediatr. 2010;157:8–10.CrossRefPubMed Newburger JW, Fulton DR. Coronary revascularization in patients with Kawasaki disease. J Pediatr. 2010;157:8–10.CrossRefPubMed
36.
Zurück zum Zitat Viola N, Alghamdi AA, Al-Radi OO, Coles JG, Van Arsdell GS, Caldarone CA. Midterm outcomes of myocardial revascularization in children. J Thorac Cardiovasc Surg. 2010;139:333–8.CrossRefPubMed Viola N, Alghamdi AA, Al-Radi OO, Coles JG, Van Arsdell GS, Caldarone CA. Midterm outcomes of myocardial revascularization in children. J Thorac Cardiovasc Surg. 2010;139:333–8.CrossRefPubMed
37.
Zurück zum Zitat Legendre A, Chantepie A, Belli E, Vouhe PR, Neville P, Dulac Y, et al. Outcome of coronary artery bypass grafting performed in young children. J Thorac Cardiovasc Surg. 2010;139:349–53.CrossRefPubMed Legendre A, Chantepie A, Belli E, Vouhe PR, Neville P, Dulac Y, et al. Outcome of coronary artery bypass grafting performed in young children. J Thorac Cardiovasc Surg. 2010;139:349–53.CrossRefPubMed
38.
Zurück zum Zitat Vida VL, Torregrossa G, De Franceschi M, Padalino MA, Belli E, Berggren H, et al. European Congenital Heart Surgeons Association (ECHSA). Pediatric coronary artery revascularization: a European multicenter study. Ann Thorac Surg 2013;96:898–903.CrossRefPubMed Vida VL, Torregrossa G, De Franceschi M, Padalino MA, Belli E, Berggren H, et al. European Congenital Heart Surgeons Association (ECHSA). Pediatric coronary artery revascularization: a European multicenter study. Ann Thorac Surg 2013;96:898–903.CrossRefPubMed
39.
Zurück zum Zitat Suzuki S, Kamiya T, Ono Y, Takahashi N, Naito Y, Kou Y. Indication of aorto-coronary bypass for coronary arterial obstruction due to Kawasaki disease. Heart Vessels 1985;1:94–100.CrossRefPubMed Suzuki S, Kamiya T, Ono Y, Takahashi N, Naito Y, Kou Y. Indication of aorto-coronary bypass for coronary arterial obstruction due to Kawasaki disease. Heart Vessels 1985;1:94–100.CrossRefPubMed
40.
Zurück zum Zitat Suzuki A, Kamiya T, Ono Y, Kinoshita Y, Kawamura S, Kimura K. Clinical significance of morphologic classification of coronary arterial segmental stenosis due to Kawasaki disease. Am J Cardiol 1993;71:1169–73.CrossRefPubMed Suzuki A, Kamiya T, Ono Y, Kinoshita Y, Kawamura S, Kimura K. Clinical significance of morphologic classification of coronary arterial segmental stenosis due to Kawasaki disease. Am J Cardiol 1993;71:1169–73.CrossRefPubMed
41.
42.
Zurück zum Zitat Yamauchi H, Ochi M, Fujii M, Hinokiyama K, Ohmori H, et al. Optimal time of surgical treatment of Kawasaki coronary artery disease. J Nippon Mde Sch. 2004;71:279–86.CrossRef Yamauchi H, Ochi M, Fujii M, Hinokiyama K, Ohmori H, et al. Optimal time of surgical treatment of Kawasaki coronary artery disease. J Nippon Mde Sch. 2004;71:279–86.CrossRef
43.
Zurück zum Zitat Tsuda E, Hirata T, Matsuo O, Abe T, Sugiyama H, Yamada O. The 30-year outcome for patients after myocardial infarction due to coronary artery lesions caused by Kawasaki disease. Pediatr Cardiol. 2011;32:176–82.CrossRefPubMed Tsuda E, Hirata T, Matsuo O, Abe T, Sugiyama H, Yamada O. The 30-year outcome for patients after myocardial infarction due to coronary artery lesions caused by Kawasaki disease. Pediatr Cardiol. 2011;32:176–82.CrossRefPubMed
44.
Zurück zum Zitat Tsuda E, Hamaoka K, Suzuki H, Sakazaki H, Murakami Y, Nakagawa M, et al. A survey of the 3-decade outcome for patients with giant aneurysms caused by Kawasaki disease. Am Heart J. 2014;167:249–58.CrossRefPubMed Tsuda E, Hamaoka K, Suzuki H, Sakazaki H, Murakami Y, Nakagawa M, et al. A survey of the 3-decade outcome for patients with giant aneurysms caused by Kawasaki disease. Am Heart J. 2014;167:249–58.CrossRefPubMed
45.
Zurück zum Zitat Tsuda E, Kitamura S, Kimura K, Kobayashi J, Miyazaki S, Echigo S, et al. Long-term patency of internal thoracic artery grafts for coronary artery stenosis due to Kawasaki disease: comparison of early with recent results in small children. Am Heart J. 2007;153:995–1000.CrossRefPubMed Tsuda E, Kitamura S, Kimura K, Kobayashi J, Miyazaki S, Echigo S, et al. Long-term patency of internal thoracic artery grafts for coronary artery stenosis due to Kawasaki disease: comparison of early with recent results in small children. Am Heart J. 2007;153:995–1000.CrossRefPubMed
46.
Zurück zum Zitat Tsuda E, Fujita H, Yagihara T, Yamada O, Echigo S, Kitamura S. Competition between native flow and graft flow after coronary artery bypass grafting. Impact on indications for coronary artery bypass grafting for localized stenosis with giant aneurysms due to Kawasaki disease. Pediatr Cardiol. 2008;29:266–70.CrossRefPubMed Tsuda E, Fujita H, Yagihara T, Yamada O, Echigo S, Kitamura S. Competition between native flow and graft flow after coronary artery bypass grafting. Impact on indications for coronary artery bypass grafting for localized stenosis with giant aneurysms due to Kawasaki disease. Pediatr Cardiol. 2008;29:266–70.CrossRefPubMed
47.
Zurück zum Zitat Ogawa S, Ohkubo T, Fukazawa R, Kamisago M, Kuramochi Y, UchikobaY, et al. Estimation of myocardial hemodynamics before and after intervention in children with Kawasaki disease. J Am Coll Cardiol. 2004;43:653–61.CrossRefPubMed Ogawa S, Ohkubo T, Fukazawa R, Kamisago M, Kuramochi Y, UchikobaY, et al. Estimation of myocardial hemodynamics before and after intervention in children with Kawasaki disease. J Am Coll Cardiol. 2004;43:653–61.CrossRefPubMed
48.
Zurück zum Zitat Kitamura S. Long-term graft patency and surgical outcomes of coronary artery bypass surgery in children with Kawasaki disease. Saji BT et al, Kawasaki diseaseeditors. Springer, Japan 2017:407–17.CrossRef Kitamura S. Long-term graft patency and surgical outcomes of coronary artery bypass surgery in children with Kawasaki disease. Saji BT et al, Kawasaki diseaseeditors. Springer, Japan 2017:407–17.CrossRef
49.
Zurück zum Zitat Maruyama Y, Ochi M. Long-term outcomes of pediatric coronary artery bypass grafting and down-sizing operation for giant coronary aneurysm. Saji BT et al (eds) Kawasaki disease. Springer, Japan 2017:389–406.CrossRef Maruyama Y, Ochi M. Long-term outcomes of pediatric coronary artery bypass grafting and down-sizing operation for giant coronary aneurysm. Saji BT et al (eds) Kawasaki disease. Springer, Japan 2017:389–406.CrossRef
Metadaten
Titel
Review: surgical treatment of giant coronary aneurysms in pediatric patients with Kawasaki disease
verfasst von
Masami Ochi
Publikationsdatum
06.12.2017
Verlag
Springer Japan
Erschienen in
General Thoracic and Cardiovascular Surgery / Ausgabe 3/2018
Print ISSN: 1863-6705
Elektronische ISSN: 1863-6713
DOI
https://doi.org/10.1007/s11748-017-0877-7

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