Surgical management of giant multiple aneurysms after Kawasaki disease in a teenager

Giuseppe Fischetti^1*Lorenzo Giovannico¹Giovanni Meliota²Nicola Di Bari¹Domenico Parigino¹Maristella Lombardi²Ugo Vairo²Tomaso Bottio¹Massimo A Padalino^1*

• ¹Cardiac Surgery Unit, Department of Precision and Regenerative Medicine and Jonian Area, University of Bari "Aldo Moro", Bari, Italy
• ²Pediatric Cardiology Unit, Department of Pediatrics, Hospital Giovanni XIII, Bari, Italy

Kawasaki disease (KD), or mucocutaneous lymph node syndrome, is a rare systemic inflammatory condition predominantly affecting children under 5 years of age. Complications such as giant coronary artery aneurysms, although rare due to advancements in treatment, remain life-threatening.Coronary artery bypass grafting (CABG) has been a well-established treatment for severe coronary lesions caused by KD. In rare cases of ischemic cardiomyopathy in pediatric patients, heart transplantation may be the only option.We report a case of a 15-year-old male with a history of KD diagnosed at 9 months of age, complicated by giant coronary aneurysms of the left anterior descending and right coronary arteries, who underwent a successful double CABG using the left internal mammary artery) and a saphenous vein graft. ha eliminato: (LIMA 39 Commentato [MP1]: Non servono queste abbreviazioni nell abstract ha eliminato: .(SVG) 40 patient with an uneventful perinatal history who was 74 diagnosed with Kawasaki disease (KD) at 9 months of age. 75 He was initially treated with a single dose of intravenous 76 immunoglobulin (2 g/kg over 12 hours) and high-dose 77 acetylsalicylic acid (80 mg/kg/day in divided doses), 78 according to standard recommendations. This regimen is 79 considered the first-line therapy for Kawasaki disease and 80 aims to reduce systemic inflammation and prevent coronary 81 artery complications, He was initially treated with 82 intravenous immunoglobulin and high-dose aspirin but 83 rapidly developed multiple giant coronary aneurysms