CARDIAC TRANSPLANTATION FOR GIANT CORONARY-ARTERY ANEURYSMS COMPLICATING KAWASAKI-DISEASE

Coronary artery aneurysm formation is a well-known and widely reported complication of Kawasaki disease with the incidence ranging from 15 to 25%.1 Most aneurysms are small and, in general, are associated with a favorable prognosis. In contrast, giant aneurysms (>8 mm in diameter) are associated with higher morbidity and mortality, despite antiplatelet and anticoagulation therapy.2 Systemic urokinase has been used to treat coronary artery thrombosis of these aneurysms, but with limited success.3 Coronary artery bypass graft surgery currently appears to be the most effective therapy for ongoing ischemia, but serious limitations exist.4 Although cardiac transplantation now is used widely to treat a number of lethal cardiac diseases affecting children, this therapeutic approach has not been reported in the management of coronary involvement in Kawasaki disease. © 1991.