Pediatric Cardiology

, Volume 14, Issue 3, pp 169–173 | Cite as

Coronary arterial lesions due to kawasaki disease: selective coronary angiography in five cases with difficult-to-detect localized stenosis

  • Shinichi Tsubata
  • Atsuko Suzuki
  • Yasuo Ono
  • Tetsuro Kamiya
  • Ikuo Hashimoto
  • Ayumi Miyazaki
  • Fukiko Ichida
  • Toshio Okada
Case Reports

Summary

We report five cases of localized stenosis in coronary arterial lesions due to Kawasaki disease which were difficult to demonstrate by routine selective coronary angiography. Of these cases, three had localized stenosis overlapping the aneurysm, one had localized stenosis overlapping another adjacent branch, and the fifth had localized stenosis at the proximal left main trunk of the coronary artery. The reasons for difficulty in demonstrating the stenoses by routine study include: the localized stenosis was often superimposed on the aneurysm and/or the other adjacent branches, and the catheter was pushed into the inlet of the aneurysm on the proximal left main trunk. For a precise demonstration of a localized stenosis by selective coronary angiography, many angiograms from different perspectives should be taken. In addition, when a large aneurysm exists in the left main coronary artery, selective coronary angiography should be taken without pushing the catheter into the inlet of the aneurysm, and each frame of the cine coronary angiogram should be carefully examined. Care should also be taken to compare with the initial view of the projection.

Key Words

Kawasaki disease Coronary arterial lesions Localized stenosis Selective coronary angiography 

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References

  1. 1.
    Kamiya T, Suzuki A, Ono Y, Mitomori T, Fujino N (1984) Usefulness of thallium myocardial imaging to detect significant coronary artery stenosis due to Kawasaki disease [abstr.].Circulation 70 (Suppl. II): II-319Google Scholar
  2. 2.
    Kato H, Ichinose E, Yoshioka F, Takechi T, Matsunaga S, Suzuki K, Rikitake N (1982) Fate of coronary aneurysms in Kawasaki disease: serial coronary angiography and longterm follow-up study.Am J Cardiol 49: 1758–1766Google Scholar
  3. 3.
    Kondo C, Hiroe M, Nakanishi T, Takao A (1989) Detection of coronary artery stenosis in children with Kawasaki disease: usefulness of pharmacologic stress 201T1 myocardial tomography.Circulation 80: 615–624Google Scholar
  4. 4.
    Ono Y, Tanimoto T, Kijima Y, Kohata T, Suzuki A, Kamiya T, Nishimura N, Kozuka T (1982) Myocardial imaging in patients with Kawasaki disease: exercise stress imaging and serial studies [in Japanese].J Cardiography 12: 387–399Google Scholar
  5. 5.
    Pahl E, Ettedgui J, Neches WH, Park SC (1989) The value of angiography in the follow-up of coronary involvement in mucocutaneous lymph node syndrome (Kawasaki disease).JACC 14: 1318–1325Google Scholar
  6. 6.
    Suzuki A, Kamiya T, Ono Y, Kohata T, Kimura K, Takamiya M (1987) Follow-up study of coronary artery lesions due to Kawasaki disease by serial selective coronary arteriography in 200 patients.Heart Vessels 3: 159–165Google Scholar
  7. 7.
    Suzuki A, Kamiya T, Ono Y, Kohata T, Okuno M (1988) Myocardial ischemia in Kawasaki disease: follow-up study by cardiac catheterization and coronary angiography.Pediatr Cardiol 9: 1–5Google Scholar
  8. 8.
    Suzuki A, Kamiya T, Kuwahara N, Ono Y, Kohata T, Takahashi O, Kimura K, Takamiya M (1986) Coronary arterial lesions of Kawasaki disease: cardiac catheterization findings of 1100 cases.Pediatr Cardiol 7: 3–9Google Scholar
  9. 9.
    Suzuki A, Kamiya T (1991) Visualization of the coronary arterial lesions in Kawasaki disease by coronary angiography.Cardiol Young 1: 225–233Google Scholar
  10. 10.
    Tatara K, Kusakawa S (1987) Long-term prognosis of giant coronary aneurysm in Kawasaki disease: an angiographic study.J Pediatr 111: 705–710Google Scholar

Copyright information

© Springer-Verlag New York Inc. 1993

Authors and Affiliations

  • Shinichi Tsubata
    • 1
  • Atsuko Suzuki
    • 2
  • Yasuo Ono
    • 2
  • Tetsuro Kamiya
    • 2
  • Ikuo Hashimoto
    • 1
  • Ayumi Miyazaki
    • 1
  • Fukiko Ichida
    • 1
  • Toshio Okada
    • 1
  1. 1.Department of PediatricsToyama Medical and Pharmaceutical UniversityToyama CityJapan
  2. 2.Department of PediatricsNational Cardiovascular CenterOsakaJapan

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