川崎病患者选择性冠状动脉造影单中心特点及经验分析

目的 总结昆明市儿童医院川崎病并发严重冠状动脉病变(coronary artery lesion,CAL)患者选择性冠状动脉造影(coronary angiography,CAG)的特点及经验.方法 回顾性分析2017年7月至2019年10月在昆明市儿童医院行CAG的32例川崎病患儿临床资料,男23例,女9例,年龄5岁...

Analysis of coronary artery lesion in patients with Kawasaki disease in single center based on selective coronary angiography

Objectives To analyze the characteristics of selective coronary angiography(CAG)in patients with Kawasaki disease(KD)complicated with severe coronary artery lesion(CAL)in Kunming Children′s Hospital.Methods Retrospective analysis was performed on the clinical data of 32 children 23 males,9 females,with an average age of5 years and 5 months10 months-12 years and 8 months,weight of 19.8(7.5-41)kg]with KD-CAL who underwent CAG in Kunming Children′s Hospital from July 2017 to October 2019.The clinical severity of CAL evaluated by echocardiography was gradeⅢor above,or there was ischemic change in electrocardiogram(ECG).CAG was done under general anesthesia in these patients.Diameter,length and location of CAL during left ventricular end-diastolic period.Characteristics and experiences of the lesions were analyzed.Individualized treatment and follow-up plan were given according to the results of CAG.Results All the patients successfully underwent selective CAG.Patients were re-graded as gradeⅠin 8 cases,gradeⅢin 7 cases,gradeⅣin 10 cases and grade Va in 7 cases by the results of CAG.There was a total of 66 CAL in these patiens,with an average of 2.06 CAL per patient.Type analysis:there were 37 small aneurysms or dilations(56.1%),17 medium aneurysms(25.8%),3 giant aneurysms(4.5%),7 stenosis and 2 occlusion.Position analysis:there were 16 lesions in the left main artery(24.6%),17 lesions in the proximal part of the left anterior descending branch(26.2%),2 lesions in the middle part,4 lesions in the proximal part of the circumflex branch,20 lesions in the proximal part of the right coronary artery(29.2%),5 lesions in the middle part and 2 lesions in the distal part.Conclusions CAG is safe and feasible in children with KD-CAL.In our center,severe KD-CAL mainly occurs in the proximal epicardial coronary artery,especially in the proximal right coronary artery,the proximal left anterior descending branch and the left main artery.The giant aneurysm often accompanied by outlet stenosis or occlusion,for the patient with giant aneurysm,it is necessary to strengthen antithrombotic treatment and follow-up observation.