川崎病に対する冠動脈バイパス術 : 30年間の成績

概要

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This study focused on assessing the clinical outcome of coronary artery bypass grafting (CABG) in patients with Kawasaki disease (KD). Thirty eight patients (mean age, 8.8 years), including 30 male and 8 female, under-went CABG. The number of bypass grafts was 1.7 per patient. Only saphenous vein (SV) was used for graft in 9 patients in the first stage from 1976 to 1983. SV and internal thoracic artery (ITA) were used in 11 patients in the second stage from 1984 to 1987. SV, ITA, and gastroepiploic artery were used in 18 patients in the third stage after 1988. The patency rate for grafts at one month after surgery was 86, 100, and 97%, and at one and three years, 58, 61, and 94% in the first, second, and third stages, respectively. Late sudden death occurred in five patients including two adult cases. Second operations were performed in two patients with in-situ arterial grafts by off pump CABG. Total arterial grafting is preferable in CABG of KD. Patients should be followed carefully and sever exercise and stress inducing activities should be avoided to prevent sudden death. Redo surgery is also feasible using arterial conduits and off pump CABG.
東京女子医科大学の論文