Background: Kawasaki disease is an acute systemic vasculitis of childhood with possible coronary artery involvement which can cause acute coronary syndrome in children and young adults.
Purpose: to study clinical and demographic characteristics of patients with Kawasaki disease with giant coronary aneurysms, to assess long-term prognosis in these patients.
Material and methods: In 2003-2015 262 children with Kawasaki disease were examined in the University Children Hospital of the I.M. Sechenov Moscow State Medical University. The following methods of visualization of coronary arteries were used: echocardiography in all, multispiral computer tomography in 29, invasive coronary angiography in 11 patients.
Results: Aneurysms of coronary arteries were found in 84 patients (32.1%), in 15 of them aneurisms were giant (internal diameter >8 mm). During follow-up (from 0.67 to 12, median 5.8 years) intracoronary thrombi were found in 11 patients. Two of them had occlusions of the right coronary artery, 5 had coronary artery stenosis which required surgical intervention. One patient developed myocardial infarction before coronary surgery.
Conclusion: Patients with Kawasaki disease with giant aneurysms of coronary arteries are predisposed to coronary thrombosis and stenosis. Long-term management of patients with regular examination, prevention of coronary thrombosis, and timely surgical intervention are necessary for lowering the risk of life-threatening complications.
Keywords: aneurysms of the coronary arteries; coronary artery occlusion; coronary stenosis; coronary thrombosis.