Ligature of the Left Main Coronary Artery after Surgery in Kawasaki Disease: Case Report

• Published in: Revista brasileira de cirurgia cardiovascular Vol. 34; no. 1; pp. 111 - 113
• Main Authors: Barca, Laura Varela, López-Menéndez, José, Palacios, Ana Redondo, Stuart, Jorge Rodríguez-Roda
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil Sociedade Brasileira de Cirurgia Cardiovascular 01.01.2019
• Subjects: Acute Coronary Syndrome; Acute Coronary Syndrome - surgery; Acute coronary syndromes; Aneurysms; Angina pectoris; Angioplasty; Calcification; CARDIAC & CARDIOVASCULAR SYSTEMS; Cardiology; Case Report; Case reports; Competition; Computed Tomography Angiography - methods; Coronary Aneurysm; Coronary Aneurysm - diagnostic imaging; Coronary Aneurysm - etiology; Coronary Aneurysm - surgery; Coronary Artery Bypass - methods; Coronary Artery Bypass, Off-Pump; Coronary vessels; Heart surgery; Humans; Kawasaki disease; Ligation; Male; Mammary Arteries - surgery; Mucocutaneous Lymph Node Syndrome; Mucocutaneous Lymph Node Syndrome - complications; Mucocutaneous Lymph Node Syndrome - surgery; Stents; SURGERY; Thrombosis; Treatment Outcome; Veins & arteries; Young Adult; Norway; Germany; Spain; Coronary Artery Bypass, Off-Pump; Mucocutaneous Lymph Node Syndrome; Coronary Aneurysm; Acute Coronary Syndrome
• ISSN: 1678-9741; 0102-7638; 1678-9741
• DOI: 10.21470/1678-9741-2018-0029

We report a case of a 23-year-old man who was diagnosed with Kawasaki disease that progressed to a coronary aneurysm in the left main coronary artery (LMA). He had suffered from acute coronary syndrome and then underwent an emergent percutaneous coronary angioplasty, in which a polyurethane-covered stent was placed inside the aneurysm. The stent was thrombosed one year later, despite the patient had been treated with anticoagulant and antiplatelet therapy. Emergency percutaneous intervention was then performed. LMA was reopened and stent malposition was observed. Therefore, urgent coronary bypass grafting was performed in which a high degree of competitive flow was observed through the reopened stent. LMA was ligated at the inflow of the aneurysm, resulting in an improvement of graft flow. Left main ligature has not been previously reported.