Kawasaki disease is an inflammation of the blood vessels known as vasculitis. It typically develops in young children with over 80% of patients under the age of 5, affects boys more than girls, and a higher percentage are of Asian ancestry. This inflammation can lead to severe inflammatory heart and blood vessel damage.
According to the American Heart Association, Kawasaki disease is the most common cause of pediatric coronary artery disease with more than 4,000 new diagnoses each year. As many as a quarter of those will develop cardiac problems.
A recently completed 25-year follow up study has shown that coronary artery bypass grafting (CABG), or bypass surgery, provides long-term benefits for adolescents and children who have Kawasaki disease with cardiac involvement.
To evaluate the long-term success in patients who had undergone CABG surgery, Dr. Soichiro Kitamura, of the National Cardiovascular Center in Osaka, Japan, and his colleagues followed 114 patients for up to 25 years. All of the patients had bypass surgery between the ages of 1 and 19 years old.
Of these 114 patients, 95% were still alive 25 years later, and most of them were free from any limitations in daily activities, according to Dr. Kitamura. Even though the number of cardiac events increased through the 25 year follow-up, the majority of the events were managed successfully.
There were five deaths among the patients that were tracked, all cardiac in nature. All of these patients had a history of heart attack and frequent irregular heart beat.
At the conclusion of follow-up, three quarters of the surviving patients were taking one to six medications. They were all taking aspirin. Other medications included warfarin, ACE inhibitors, angiotensin receptor blockers, calcium antagonists, diuretics, nitrates, statins, and beta-blockers.
All of the survivors were symptom free at the last checkup and 80% did not have any limitations in performing daily activities. Most could play sports.
The researchers stated that Kawasaki disease has been increasingly treated with early gamma-globulin administration and PCI instead of surgery, although the long-term benefits of these therapies remain unknown.
According to the researchers, “prolonged observation is mandatory for these patients. By employing early additional therapeutic procedures such as percutaneous coronary intervention (PCI) and redo operations, the patients’ survival and quality of life were favorably influenced during 25 postoperative years.”
Dr. Kitamura performed the first bypass grafts in patients with Kawasaki disease in the late 1970s and early 1980s.
The research was published online in Circulation: Journal of the American Heart Association.
loading...
Ther are currently no related posts.
