川崎病冠状动脉病变及搭桥手术

目的 探讨川崎病后严重冠状动脉病变及搭桥手术（ＣＡＢＧ）后的近期及远期效果。方法随访发现，６例川崎病后严重冠状动脉病变的病儿均有左冠状动脉前降支（ＬＡＤ）病变，右冠状动脉（ＲＣＡ）病变５例，左冠状动脉回旋支（ＬＣＸ）病变３例，左冠状动脉主干（ＬＭＴ）病变２例，心肌梗死３例。共行１５支ＣＡＢＧ；单支２例，３支３例，４支１例；左胸廓内动脉（ＬＩＴＡ）至ＬＡＤ６例；右胸廓内动脉（ＲＩＴＡ）至ＬＡＤ１例。

Coronary artery bypass grafting in patients with severe coronary artery lesions caused by Kawasaki disease

Objective: To investigate the result of coronary artery bypass grafting (CABG) in patients with severe coronary artery lesions caused by Kawasaki disease. Methods: We retrospectively analyzed 15 CABGs performed in 6 patients (5 male and 1 female) by angiography. Lesions involved the left anterior descending coronary artery (LAD) in 6patients, the right coronary artery (RCA) in 5, the left circumflex artery (LCX) in 3 and the left main coronary artery (LMT) in 2. Three patients had history of previous myocardial infarction. Left internal thoracic artery (LITA) grafts to the LAD were performed in six patients, right internal thoracic artery (RITA) grafts to the LAD in 1 and to the LCX in 1. Right gastroepiploic artery (RGEA) grafts to the RCA were performed in two patients. Saphenous vein grafts (SVGs) to the LAD were performed in three patients and to LCX in 2. Results: One month after the operation, RGEA graft to the RCA was stenotic in one patient, LITA graft to the LAD was occluded in one patient, and the remaining grafts were patent. During the follow-up period of 1 to 4 years, a SVG to the LCX and a LITA graft to the LAD were severely stenotic in one patient who received four CABGs. The left ventricular contraction was improved and no myocardial infarction was noted in any patients after bypass surgery. Conclusion: CABG could improve the left ventricular contraction and decrease the occurrence of myocardial infarction after surgery. However, occlusion and stenosis rate of grafts is comparatively higher.