Why is surgery necessary for Kawasaki disease coronary artery aneurysm?

If there is an abnormality in the human coronary artery, the function of the heart will also be affected. If Kawasaki disease causes vascular inflammation, the impact on the coronary artery is relatively large. It is likely to cause thinning of the blood vessel wall, and then under pressure, a small bag will appear in the thinned area. This small bag is called Kawasaki disease coronary artery aneurysm. If you suffer from Kawasaki disease coronary artery aneurysm, you must seek treatment as soon as possible.

Why do some children with Kawasaki disease and coronary artery aneurysms need interventional or bypass surgery?

The treatment process of Kawasaki disease coronary artery aneurysm is very long, especially for medium-sized and giant coronary artery aneurysms. It usually takes 3 to 5 years for the inner diameter of the coronary artery aneurysm to gradually shrink. If coronary artery stenosis, coronary artery thrombosis or myocardial infarction occurs during this process, a doctor needs to intervene:

First, if a blood clot has formed, coronary artery thrombolysis or intravenous thrombolysis therapy is required.

Second, if coronary artery stenosis occurs and blood flow is obstructed, interventional treatment will be required, such as placing a stent in the blood vessel to expand the blood vessel. Although interventional treatment methods can clear coronary arteries, they also have some defects. Because the coronary artery stenosis caused by Kawasaki disease coronary artery aneurysm is different from the stenosis caused by adult coronary heart disease and coronary atherosclerosis, these narrowed arteries are prone to calcification, and the success rate of interventional treatment is relatively low. In addition, even if the coronary arteries are dilated, there is still a 20% chance of forming new tumors. Therefore, interventional treatment is currently only used for stenosis caused by a single coronary artery aneurysm.

Third, if coronary artery stenosis occurs or a myocardial infarction has already occurred, surgical coronary artery bypass grafting can be performed. In other words, if this blood vessel is blocked and blood can't flow through it, we build a bridge for it to allow the blood to take a detour. Currently, bypass surgery is an ideal treatment for these children, but which children can undergo bypass surgery still requires pediatric cardiologists to evaluate the children's conditions.

How long does it take to treat Kawasaki disease coronary artery aneurysm?

The duration of treatment for Kawasaki disease coronary artery aneurysm is determined based on the individual child's condition.

For children with small or medium-sized tumors, the average treatment time is 3 to 5 years. However, if the inner diameter of the coronary arteries of these children returns to normal levels within one or two years, the medication can be stopped and the children can be followed up until adolescence to observe whether coronary artery stenosis will occur after the coronary arteries return to normal.

The treatment time for children with giant tumors is very long, possibly 5 to 10 years. Some children even need to go to the adult cardiology department for long-term follow-up after they grow up and turn 18.