The Spectrum of Cardiovascular Lesions Requiring Intervention in Adults After Kawasaki Disease
| العنوان: | The Spectrum of Cardiovascular Lesions Requiring Intervention in Adults After Kawasaki Disease |
|---|---|
| المؤلفون: | Gordon, JB, Daniels, LB, Kahn, AM, Jimenez-Fernandez, S, Vejar, M, Numano, F, Burns, JC |
| المصدر: | JACC. Cardiovascular interventions, vol 9, iss 7 Gordon, JB; Daniels, LB; Kahn, AM; Jimenez-Fernandez, S; Vejar, M; Numano, F; et al.(2016). The Spectrum of Cardiovascular Lesions Requiring Intervention in Adults After Kawasaki Disease. JACC-CARDIOVASCULAR INTERVENTIONS, 9(7), 687-696. doi: 10.1016/j.jcin.2015.12.011. UC San Diego: Retrieved from: http://www.escholarship.org/uc/item/4f60m4qr |
| بيانات النشر: | eScholarship, University of California, 2016. |
| سنة النشر: | 2016 |
| مصطلحات موضوعية: | Adult, Male, Cardiac Catheterization, Time Factors, Adolescent, Biopsy, Myocardial Infarction, Mucocutaneous Lymph Node Syndrome, Cardiorespiratory Medicine and Haematology, Coronary Angiography, vasculitis, Angina Pectoris, Young Adult, Percutaneous Coronary Intervention, Humans, cardiovascular diseases, Longitudinal Studies, Coronary Artery Bypass, pediatric acquired heart disease, Ultrasonography, Peripheral Vascular Diseases, Heart Failure, claudication, Interventional, Endovascular Procedures, Coronary Aneurysm, Age Factors, Middle Aged, coronary artery aneurysm, Treatment Outcome, Cardiovascular System & Hematology, Heart Transplantation, Female |
| الوصف: | ObjectivesThe aim of this study was to characterize the range of management issues raised by adults with cardiovascular sequelae from Kawasaki disease (KD) in childhood.BackgroundAneurysms resulting from vascular inflammation associated with KD in childhood may remain clinically silent until adulthood. Adults with large aneurysms, unstable angina, or myocardial infarction following KD in childhood present unique challenges to interventional cardiologists and cardiothoracic surgeons.MethodsIn an observational study of adults with histories of KD in childhood, data were collected regarding the medical histories and outcomes of 154 adult KD patients, of whom 21 underwent either percutaneous interventions or surgery.ResultsOf the 21 subjects with interventions, 11 had been diagnosed with KD in childhood, and 10 had histories of KD-compatible illnesses. Seventeen subjects were asymptomatic until experiencing acute cardiovascular symptoms: acute myocardial infarction (n = 12), angina (n = 2), end-stage congestive heart failure requiring cardiac transplantation (n = 1), and claudication (n = 2).ConclusionsCardiovascular complications in these subjects illustrate the following points: 1) even small to moderate-sized aneurysms that "normalize" on echocardiography in childhood can lead to stenosis and thrombosis decades after the acute illness; 2) coronary interventions without intravascular ultrasound may result in clinically significant underestimation of vessel luminal diameter; 3) failure to assess the extent of calcification may lead to suboptimal procedural outcomes; and 4) patients with symptomatic peripheral aneurysms may benefit from endarterectomy or resection. Interventional cardiologists should be aware of the potential challenges in treating this growing population of adults. |
| وصف الملف: | application/pdf |
| DOI: | 10.1016/j.jcin.2015.12.011. |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=dedup_wf_001::78210bb9571a8a79c457af25349ebd9d https://escholarship.org/uc/item/4f60m4qr |
| Rights: | OPEN |
| رقم الانضمام: | edsair.dedup.wf.001..78210bb9571a8a79c457af25349ebd9d |
| قاعدة البيانات: | OpenAIRE |
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JACC-CARDIOVASCULAR INTERVENTIONS, 9(7), 687-696. doi: 10.1016/j.jcin.2015.12.011. 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Adults with large aneurysms, unstable angina, or myocardial infarction following KD in childhood present unique challenges to interventional cardiologists and cardiothoracic surgeons.MethodsIn an observational study of adults with histories of KD in childhood, data were collected regarding the medical histories and outcomes of 154 adult KD patients, of whom 21 underwent either percutaneous interventions or surgery.ResultsOf the 21 subjects with interventions, 11 had been diagnosed with KD in childhood, and 10 had histories of KD-compatible illnesses. Seventeen subjects were asymptomatic until experiencing acute cardiovascular symptoms: acute myocardial infarction (n = 12), angina (n = 2), end-stage congestive heart failure requiring cardiac transplantation (n = 1), and claudication (n = 2).ConclusionsCardiovascular complications in these subjects illustrate the following points: 1) even small to moderate-sized aneurysms that "normalize" on echocardiography in childhood can lead to stenosis and thrombosis decades after the acute illness; 2) coronary interventions without intravascular ultrasound may result in clinically significant underestimation of vessel luminal diameter; 3) failure to assess the extent of calcification may lead to suboptimal procedural outcomes; and 4) patients with symptomatic peripheral aneurysms may benefit from endarterectomy or resection. 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