15-year Follow up of Right Gastroepiploic Artery Grafting in Pediatric Patients with Kawasaki Disease

Coronary artery bypass grafting (CABG) for children with severe coronary artery damage due to Kawasaki disease (KD) has been performed since 1974. Initially, the saphenous vein served as the principal conduit. However saphenous vein graft patency was found to decline sharply during the first few years after surgery. Using the internal thoracic artery (ITA) improved graft patency rate after CABG. In 1988, we first successfully applied the GEA for revascularization to the distal portion, where ITA was difficult to reach. Here, we are reporting the progress, after 15 years, of two KD patients with GEA grafting. They underwent CABG using GEA at 7 and 11 years, respectively, and demonstrated normal growth and development during follow up. Angiographic examination 10 years after CABG, showed excellent patent GEA in one case. In the second case, flow competition with native coronary blood flow supplied from collateral flow from the left coronary artery was observed. The long-term effects of KD are still not well known. There have also been few reports concerned with the long-term results of GEA grafting in KD patients