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Pan Y, Jiao FY. Relationship between Kawasaki disease and abdominal pain. World J Clin Cases 2024; 12:2932-2934. [PMID: 38898859 PMCID: PMC11185365 DOI: 10.12998/wjcc.v12.i17.2932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 04/10/2024] [Accepted: 04/23/2024] [Indexed: 06/04/2024] Open
Abstract
This editorial presents an analysis of an article recently published in the World Journal of Clinical Cases. Kawasaki disease (KD) is a well-known pediatric vasculitis characterized by fever, rash, conjunctivitis, oral mucosal changes, and swelling of the extremities. This editorial aims to delve into the intricate relationship between KD and abdominal pain, drawing insights from recent research findings to provide a comprehensive understanding and potential avenues for future investigation.
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Affiliation(s)
- Yan Pan
- Department of Pediatrics, The First Affiliated Hospital of Yangtze University, Jingzhou 434000, Hubei Province, China
| | - Fu-Yong Jiao
- Shaanxi Kawasaki Disease Diagnosis and Treatment Center, Children's Hospital, Shaanxi Provincial People's Hospital of Xi'an Jiaotong University, Xi'an 710000, Shaanxi Province, China
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Wang Z, Sun Y, Zhou C, Shi J. Surgical treatment of coronary artery lesions in children with Kawasaki disease. J Card Surg 2022; 37:4334-4339. [PMID: 36183407 DOI: 10.1111/jocs.16999] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 08/24/2022] [Indexed: 01/06/2023]
Abstract
OBJECTIVES This study aimed to explore the efficacy of different surgical treatment for coronary artery lesions (CALs) caused by Kawasaki disease (KD) in children. METHODS We retrospectively analyzed the records of children with KD who presented with CALs to our hospital between 2015 and 2022. The patients were aged 126 ± 44.3 months (range: 84-180 months), and their body weight was 37.1 ± 18.6 kg (range: 17-60 kg). All patients were diagnosed with KD and were treated with standard medications. The patients had CALs for an average of 78 months (range: 24-156 months). All children underwent surgical treatment. In addition, one patient underwent cardiac defibrillator implantation, two underwent coronary artery bypass grafting (CABG), and one underwent heart bypass transplantation. The internal thoracic artery was used as the source of the left anterior descending branch bridge tube. The no-touch technique was used to obtain the free right thigh great saphenous vein as the bridge tube of the right coronary artery. RESULTS All four patients had good postoperative recovery and the cardiac ultrasonography showed improved cardiac function and smooth coronary artery blood flow. The preoperative left ventricular ejection fraction was 44 ± 23.4%, which was significantly improved to 61.4 ± 14.0% postoperatively (p > .05). The preoperative left ventricle size was 5.6 ± 1.6 cm, which was significantly improved to 4.0 ± 0.6 cm postoperatively (p > .05). The two patients who underwent CABG received oral aspirin (5 mg/kg) and clopidogrel (1 mg/kg) antiplatelet therapy. The patients received oral tacrolimus antirejection drugs after the heart transplantation. The postoperative cardiac function was above grade II, and there were no symptoms of cardiac insufficiency, such as syncope, chest tightness, and orthopnea. CONCLUSIONS Patients with CALs due to KD should be treated in a timely manner. The selection of an appropriate surgical treatment leads to prolonged survival and improved quality of life of patients.
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Affiliation(s)
- Zhijie Wang
- Union Hospital Affiliated to Tongji Medical College of Huazhong University of science and technology, Wuhan, China.,Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yongfeng Sun
- Union Hospital Affiliated to Tongji Medical College of Huazhong University of science and technology, Wuhan, China.,Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Cheng Zhou
- Union Hospital Affiliated to Tongji Medical College of Huazhong University of science and technology, Wuhan, China.,Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiawei Shi
- Union Hospital Affiliated to Tongji Medical College of Huazhong University of science and technology, Wuhan, China.,Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Magro P, Carvalho N, Anjos R, Neves J. Coronary artery bypass grafting in a child with Kawasaki disease. Rev Port Cardiol 2021; 40:519.e1-519.e4. [PMID: 34274100 DOI: 10.1016/j.repce.2021.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 05/13/2018] [Indexed: 11/18/2022] Open
Abstract
Kawasaki disease (KD) with cardiac involvement can result in the development of coronary aneurysm, stenosis or thrombosis with significant cardiovascular implications. We report the case of a 23-month-old male with a late diagnosis of KD, in whom intravenous immunoglobulin treatment was not feasible. The patient's course was assessed by routine echocardiography. At the age of five years, angiographic assessment revealed an aneurysm of the anterior descending coronary artery measuring 17 mm×7 mm involving the first diagonal branch, 90% post-aneurysmal stenosis, and an aneurysm of the right coronary artery measuring 32 mm×6 mm. Due to the critical anatomy of the anterior descending artery the revascularization method of choice was coronary artery bypass surgery with an internal mammary artery graft, under cardiopulmonary bypass. There were no significant intraoperative or postoperative complications. This confirms coronary artery bypass grafting as a reliable treatment option for patients who present with coronary sequelae from KD, even at a very young age.
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Affiliation(s)
- Pedro Magro
- Department of Cardiothoracic Surgery, Santa Cruz Hospital, Carnaxide, Portugal.
| | - Nuno Carvalho
- Department of Pediatric Cardiology, Santa Cruz Hospital, Carnaxide, Portugal
| | - Rui Anjos
- Department of Pediatric Cardiology, Santa Cruz Hospital, Carnaxide, Portugal
| | - José Neves
- Department of Cardiothoracic Surgery, Santa Cruz Hospital, Carnaxide, Portugal
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Magro P, Carvalho N, Anjos R, Neves J. Coronary artery bypass grafting in a child with Kawasaki disease. Rev Port Cardiol 2021. [PMID: 34083099 DOI: 10.1016/j.repc.2018.05.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Kawasaki disease (KD) with cardiac involvement can result in the development of coronary aneurysm, stenosis or thrombosis with significant cardiovascular implications. We report the case of a 23-month-old male with a late diagnosis of KD, in whom intravenous immunoglobulin treatment was not feasible. The patient's course was assessed by routine echocardiography. At the age of five years, angiographic assessment revealed an aneurysm of the anterior descending coronary artery measuring 17 mm×7 mm involving the first diagonal branch, 90% post-aneurysmal stenosis, and an aneurysm of the right coronary artery measuring 32 mm×6 mm. Due to the critical anatomy of the anterior descending artery the revascularization method of choice was coronary artery bypass surgery with an internal mammary artery graft, under cardiopulmonary bypass. There were no significant intraoperative or postoperative complications. This confirms coronary artery bypass grafting as a reliable treatment option for patients who present with coronary sequelae from KD, even at a very young age.
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Affiliation(s)
- Pedro Magro
- Department of Cardiothoracic Surgery, Santa Cruz Hospital, Carnaxide, Portugal.
| | - Nuno Carvalho
- Department of Pediatric Cardiology, Santa Cruz Hospital, Carnaxide, Portugal
| | - Rui Anjos
- Department of Pediatric Cardiology, Santa Cruz Hospital, Carnaxide, Portugal
| | - José Neves
- Department of Cardiothoracic Surgery, Santa Cruz Hospital, Carnaxide, Portugal
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Wang T, Wang C, Zhou KY, Wang XQ, Hu N, Hua YM. Incomplete Kawasaki disease complicated with acute abdomen: A case report. World J Clin Cases 2020; 8:5457-5466. [PMID: 33269284 PMCID: PMC7674722 DOI: 10.12998/wjcc.v8.i21.5457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 09/04/2020] [Accepted: 09/28/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Kawasaki disease (KD) is an acute systemic vasculitis characterized by unknown etiology.
CASE SUMMARY A 4.5-year-old boy developed an acute abdomen during the onset of incomplete KD. He still had persistent abdominal pain after undergoing exploratory laparotomy and appendectomy. Ultrasound examination at early onset revealed a giant coronary artery aneurysm. The patient developed a myocardial infarction and heart failure accompanied by respiratory and cardiac arrest. He underwent coronary artery revascularization and coronary artery bypass graft using an autologous internal mammary artery. After the operation, the cardiac output increased, and the symptoms of heart failure resolved. Follow-up evaluation at 1 mo after operation showed that the patient's cardiac function had restored to New York Heart Association standard Grade I heart failure, and normal growth was obtained.
CONCLUSION Coronary artery revascularization and coronary artery bypass graft is an effective method for treating myocardial ischemia in children with KD complicated with giant coronary artery aneurysm . Nevertheless, some issues still need specific attention.
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Affiliation(s)
- Tao Wang
- Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610065, Sichuan Province, China
- Key Laboratory of Obstetric and Gynecologic and Pediatric Diseases of Sichuan Province, Chengdu 610041, Sichuan Province, China
| | - Chuan Wang
- Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610065, Sichuan Province, China
- Key Laboratory of Obstetric and Gynecologic and Pediatric Diseases of Sichuan Province, Chengdu 610041, Sichuan Province, China
| | - Kai-Yu Zhou
- Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610065, Sichuan Province, China
- Key Laboratory of Obstetric and Gynecologic and Pediatric Diseases of Sichuan Province, Chengdu 610041, Sichuan Province, China
| | - Xiao-Qin Wang
- Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610065, Sichuan Province, China
- Key Laboratory of Obstetric and Gynecologic and Pediatric Diseases of Sichuan Province, Chengdu 610041, Sichuan Province, China
| | - Na Hu
- Department of Medical Imaging, West China Hospital/West China School of Medicine, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yi-Min Hua
- Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610065, Sichuan Province, China
- Key Laboratory of Obstetric and Gynecologic and Pediatric Diseases of Sichuan Province, Chengdu 610041, Sichuan Province, China
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Wang T, Wang C, Zhou KY, Wang XQ, Hu N, Hua YM. Incomplete Kawasaki disease complicated with acute abdomen: A case report. World J Clin Cases 2020. [PMID: 33269284 DOI: 10.12998/wjcc.v8.i21.5457.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Kawasaki disease (KD) is an acute systemic vasculitis characterized by unknown etiology. CASE SUMMARY A 4.5-year-old boy developed an acute abdomen during the onset of incomplete KD. He still had persistent abdominal pain after undergoing exploratory laparotomy and appendectomy. Ultrasound examination at early onset revealed a giant coronary artery aneurysm. The patient developed a myocardial infarction and heart failure accompanied by respiratory and cardiac arrest. He underwent coronary artery revascularization and coronary artery bypass graft using an autologous internal mammary artery. After the operation, the cardiac output increased, and the symptoms of heart failure resolved. Follow-up evaluation at 1 mo after operation showed that the patient's cardiac function had restored to New York Heart Association standard Grade I heart failure, and normal growth was obtained. CONCLUSION Coronary artery revascularization and coronary artery bypass graft is an effective method for treating myocardial ischemia in children with KD complicated with giant coronary artery aneurysm . Nevertheless, some issues still need specific attention.
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Affiliation(s)
- Tao Wang
- Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Chuan Wang
- Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Kai-Yu Zhou
- Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Xiao-Qin Wang
- Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Na Hu
- Department of Medical Imaging, West China Hospital/West China School of Medicine, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yi-Min Hua
- Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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Marchesi A, Tarissi de Jacobis I, Rigante D, Rimini A, Malorni W, Corsello G, Bossi G, Buonuomo S, Cardinale F, Cortis E, De Benedetti F, De Zorzi A, Duse M, Del Principe D, Dellepiane RM, D’Isanto L, El Hachem M, Esposito S, Falcini F, Giordano U, Maggio MC, Mannarino S, Marseglia G, Martino S, Marucci G, Massaro R, Pescosolido C, Pietraforte D, Pietrogrande MC, Salice P, Secinaro A, Straface E, Villani A. Kawasaki disease: guidelines of Italian Society of Pediatrics, part II - treatment of resistant forms and cardiovascular complications, follow-up, lifestyle and prevention of cardiovascular risks. Ital J Pediatr 2018; 44:103. [PMID: 30157893 PMCID: PMC6116479 DOI: 10.1186/s13052-018-0529-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 07/29/2018] [Indexed: 02/08/2023] Open
Abstract
This second part of practical Guidelines related to Kawasaki disease (KD) has the goal of contributing to prompt diagnosis and most appropriate treatment of KD resistant forms and cardiovascular complications, including non-pharmacologic treatments, follow-up, lifestyle and prevention of cardiovascular risks in the long-term through a set of 17 recommendations.Guidelines, however, should not be considered a norm that limits the treatment options of pediatricians and practitioners, as treatment modalities other than those recommended may be required as a result of peculiar medical circumstances, patient's condition, and disease severity or individual complications.
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Affiliation(s)
| | | | - Donato Rigante
- Università Cattolica Sacro Cuore, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy
| | | | | | | | | | - Sabrina Buonuomo
- Bambino Gesù Children’s Hospital, Piazza S. Onofrio n. 4, 00165 Rome, Italy
| | | | | | | | - Andrea De Zorzi
- Bambino Gesù Children’s Hospital, Piazza S. Onofrio n. 4, 00165 Rome, Italy
| | - Marzia Duse
- Università degli Studi Sapienza, Rome, Italy
| | | | | | | | - Maya El Hachem
- Bambino Gesù Children’s Hospital, Piazza S. Onofrio n. 4, 00165 Rome, Italy
| | | | | | - Ugo Giordano
- Bambino Gesù Children’s Hospital, Piazza S. Onofrio n. 4, 00165 Rome, Italy
| | | | | | | | | | - Giulia Marucci
- Bambino Gesù Children’s Hospital, Piazza S. Onofrio n. 4, 00165 Rome, Italy
| | | | | | | | | | | | - Aurelio Secinaro
- Bambino Gesù Children’s Hospital, Piazza S. Onofrio n. 4, 00165 Rome, Italy
| | | | - Alberto Villani
- Bambino Gesù Children’s Hospital, Piazza S. Onofrio n. 4, 00165 Rome, Italy
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Kawasaki Disease Increases the Incidence of Myopia. BIOMED RESEARCH INTERNATIONAL 2017; 2017:2657913. [PMID: 28828383 PMCID: PMC5554556 DOI: 10.1155/2017/2657913] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 04/30/2017] [Accepted: 06/11/2017] [Indexed: 12/29/2022]
Abstract
The prevalence of myopia has rapidly increased in recent decades and has led to a considerable global public health concern. In this study, we elucidate the relationship between Kawasaki disease (KD) and the incidence of myopia. We used Taiwan's National Health Insurance Research Database to conduct a population-based cohort study. We identified patients diagnosed with KD and individuals without KD who were selected by frequency matched based on sex, age, and the index year. The Cox proportional hazards regression model was used to estimate the hazard ratio and 95% confidence intervals for the comparison of the 2 cohorts. The log-rank test was used to test the incidence of myopia in the 2 cohorts. A total of 532 patients were included in the KD cohort and 2128 in the non-KD cohort. The risk of myopia (hazard ratio, 1.31; 95% confidence interval, 1.08-1.58; P < 0.01) was higher among patients with KD than among those in the non-KD cohort. The Cox proportional hazards regression model showed that irrespective of age, gender, and urbanization, Kawasaki disease was an independent risk factor for myopia. Patients with Kawasaki disease exhibited a substantially higher risk for developing myopia.
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Abstract
INTRODUCTION Coronary artery aneurysm (CAA) is defined as coronary dilatation which exceeds the diameter of the normal adjacent artery segments or the diameter of the patient's largest coronary artery by 1.5 times. The incidence of giant CAA is difficult to be determined, since only few reports have been described in the literature. METHODS AND RESULTS A 65-year-old man was referred to our hospital because of a "mass" in the right heart detected on echocardiography at a regular medical health examination, while he experienced no any symptoms. Coronary angiography showed the severe stenosis of the left anterior descending artery (LAD) and the left circumflex artery (LCX) and the diffusely ectatic change of the right coronary artery (RCA), but no mass was found in any of these arteries. Coronary computed tomography angiography (CTA) confirmed that the "mass" was the giant aneurysms of RCA with thrombus. He received coronary artery bypass graft (CABG) with thrombectomy. The histopathology showed the deposits of lipid and hyalin in the tunica intima, the focal calcifications, the very thin tunica media, and the disappearance of the part of the tunica media in the RCA. CONCLUSIONS Coronary artery aneurysm which may contain thrombus can complicate a diagnostic coronary angiography due to the risk of distal embolization and may lead to myocardial infarction. This case report demonstrates 2 RCA aneurysms with a thrombus presenting as a giant "mass" which was successfully treated by CABG with thrombectomy.
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Affiliation(s)
- Huanhuan Wang
- Division of Cardiology
- Correspondence: Huanhuan Wang, Division of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Beijing, China (e-mail: )
| | | | | | - Hongyue Wang
- Division of Pathology, Fuwai Hospital, National Center for Cardiovascular Disease, Beijing, China
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Parsa SA, Khaheshi I, Paydary K, Haybar H. Acute myocardial infarction in a 35-year-old man with coronary artery aneurysm most probably caused by Kawasaki disease. Asian Pac J Trop Biomed 2014; 4:S50-2. [PMID: 25183138 DOI: 10.12980/apjtb.4.2014c988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 03/18/2014] [Indexed: 10/25/2022] Open
Abstract
We present a 35-year-old man with history of Kawasaki disease who referred with myocardial infarction, and angiography, revealing aneurysm of left main and left anterior descending coronary arteries. The patient underwent percutaneous coronary intervention and thrombectomy and was discharged after 6 d. Coronary artery sequels of Kawasaki disease should be considered as one of the underlying causes of acute myocardial infarction in young adults.
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Affiliation(s)
- Saeed Alipour Parsa
- Cardiovascular Research Center, Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Isa Khaheshi
- Cardiovascular Research Center, Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Koosha Paydary
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Habib Haybar
- Cardiovascular Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Yuan SM. Cardiac surgical procedures for the coronary sequelae of Kawasaki disease. Libyan J Med 2012; 7:19796. [PMID: 23226165 PMCID: PMC3514494 DOI: 10.3402/ljm.v7i0.19796] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2012] [Accepted: 10/29/2012] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES The aim of this article is to make an evaluation on the clinical features of patients with Kawasaki disease who require a cardiac surgical procedure including coronary artery bypass grafting, coronary arterial aneurysmorrhaphy or heart transplantation. METHODS English literature of Kawasaki disease for cardiac surgery (1990-2011) was retrieved in the Pubmed database. The clinical features of the patient setting from the representative articles were collected and analyzed. RESULTS Patients with Kawasaki disease were very young, with some requiring a cardiac surgical procedure at a very early age. The interval between the onset and the surgical operation was 9.5±9.4 years. The prevalence of myocardial infarction and re-infarction was high. Giant aneurysm, critical stenosis with calcification and thrombus formation of the coronary arteries often warrant coronary artery bypass, heart transplantation or coronary arterial aneurysm plication. The left internal mammary artery to the left anterior descending coronary artery was the most commonly used graft in coronary artery bypass. Graft patency rate was 82.4% at 21.4±32.3 (range 0.1-252) month follow-up. The early and late mortalities of this patient setting were 0.6 and 3.0%, respectively. CONCLUSIONS Patients with Kawasaki disease may develop coronary artery lesions prone to aneurysmal formation with calcification and thrombus and may require coronary artery bypass at a very early age. With the left internal mammary artery as the first choice of bypass graft, the long-term patency and patient survival was satisfactory.
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Affiliation(s)
- Shi-Min Yuan
- Department of Cardiothoracic Surgery, The First Hospital of Putian, Teaching Hospital, Fujian Medical University, Putian, Fujian Province, People's Republic of China.
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