Stent Placement for Coronary Stenosis in Kawasaki Disease: Case Report and Literature Review

A 48-year-old male patient diagnosed with Kawasaki disease in childhood presented with recurrent angina afer undergoing coronary artery bypass surgery in 1996. Percutaneous transluminal coronary angioplasty and intracoronary stent placement to a lesion in the proximal ramus intermedius were performed successfully. This case illustrates the complementary nature of percutaneous and surgical myocardial revascularization strategies in appropriately selected patients with Kawasaki disease. (J Interven Cardiol2002; 1529-32) Case Report A 48-year-old male with a past medical history of Kawasaki disease diagnosed in childhood was referred for cardiac catheterization for recurrent angina and ab-normal myocardial perfusion study. Prior cardiovascu-lar history was significant for two anterior wall my-ocardial infarctions in 1987, followed by coronary artery bypass grafting (CABG) in 1996. Surgery con-sisted of left internal mammary artery (IMA) graft to the left anterior descending (LAD) artery, saphenous vein graft to the first diagonal artery, saphenous vein graft to the first obtuse marginal artery, and saphenous vein graft to the right posterior descending artery. In July 1998, the patient suffered an inferior wall myocardial infarction treated with angioplasty and stent placement to the saphenous vein graft supplying the right posterior descending artery. The procedure was uneventful, and he was discharged in stable con-dition. In February 1999, he developed recurrent angina pectoris, which led to intensification of his medical therapy and performance of gated Sestamibi single photon emission computed tomograph