Abstract 224: Repeat Coronary Artery Bypass Grafting in an Adult Case of Kawasaki Disease

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Background: The incidence of giant coronary artery aneurysm as a complication of Kawasaki disease is approximately 0.35%. Kawasaki disease was first described in 1967. However, only a few studies have reported on adult cases of cardiovascular sequelae in Kawasaki disease. Adult cases of coronary stenosis due to Kawasaki disease shows a predilection for the age range of late teens to the twenties; elderly onset, such as around the age of 60 years, is rare.

Case report: A 62-year-old woman with a history of coronary artery bypass grafting (two-vessel bypass) was diagnosed with a coronary artery aneurysm and concomitant Kawasaki disease at another hospital at the age of 48 years. A reoperation was recommended owing to re-strangulation, but the patient opted for progress observation. At the age of 53 years, the patient experienced respiratory pain during laborious work, and coronary angiography was indicated. We therefore performed coronary artery bypass grafting (four-vessel bypass) for there to base Kawasaki disease, calcification of advanced, restenosis, coronary flow was observed. The postoperative course was good, and the patient has remained without restenosis for 9 years after the surgery.

Conclusion: The progress of patients with a history of Kawasaki disease in adulthood has not been established; these patients therefore require periodical follow-up examinations. Moreover, because coronary artery involvement in Kawasaki disease is a risk factor for myocardial infarction, careful attention should be paid to lifestyle-related diseases.

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