Coronary Wall Structural Changes in Patients With Kawasaki Disease: New Insights From Optical Coherence Tomography (OCT)

Background Coronary artery aneurysms (CAA) are serious complications of Kawasaki disease (KD). Optical coherence tomography (OCT) is a high‐resolution intracoronary imaging modality that characterizes coronary artery wall structure. The purpose of this work was to describe CAA wall sequelae after KD...

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Bibliographic Details
Published in:Journal of the American Heart Association 2015-05, Vol.4 (5), p.n/a
Main Authors: Dionne, Audrey, Ibrahim, Ragui, Gebhard, Catherine, Bakloul, Mohamed, Selly, Jean‐Bernard, Leye, Mohamed, Déry, Julie, Lapierre, Chantale, Girard, Patrice, Fournier, Anne, Dahdah, Nagib
Format: Article
Language:English
Subjects:
Adolescent
Child
Child, Preschool
Coronary Aneurysm - diagnosis
Coronary Aneurysm - etiology
Coronary Angiography - methods
coronary disease
Coronary Vessels - pathology
Female
Follow-Up Studies
Humans
imaging
Male
Mucocutaneous Lymph Node Syndrome - complications
Nitroglycerin - administration & dosage
Original Research
pediatrics
Tomography, Optical Coherence - methods
Vasodilator Agents - administration & dosage
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Summary:Background Coronary artery aneurysms (CAA) are serious complications of Kawasaki disease (KD). Optical coherence tomography (OCT) is a high‐resolution intracoronary imaging modality that characterizes coronary artery wall structure. The purpose of this work was to describe CAA wall sequelae after KD. Methods and Results KD patients scheduled for routine coronary angiography underwent OCT imaging between March 2013 and August 2014. Subjects’ clinical courses, echocardiography, and coronary angiography examinations were reviewed retrospectively. OCT was performed in 18 patients aged 12.4±5.5 years, 9.0±5.1 years following onset of KD. Of those, 14 patients (77.7%) had a history of CAA (7 with giant CAA and 7 with regressed CAA at time of OCT). Intracoronary nitroglycerin was given to all patients (88.4±45.5 μg/m2). Mean radiation dose was 10.9±5.2 mGy/kg. One patient suffered from a transitory uneventful vasospasm at the site of a regressed CAA; otherwise no major procedural complications occurred. The most frequent abnormality observed on OCT was intimal hyperplasia (15 patients, 83.3%) seen at both aneurysmal sites and angiographically normal segments amounting to 390.8±166.0 μm for affected segments compared to 61.7±17 μm for unaffected segments (P
ISSN:2047-9980
2047-9980
DOI:10.1161/JAHA.115.001939