Clinical Outcomes of Using Radial Artery for Coronary Artery Bypass Graft in Children With Kawasaki Disease.

INTRODUCTION

To investigate the early clinical outcomes of using radial artery (RA) graft for coronary artery bypass graft (CABG) surgery in children with coronary sequelae of Kawasaki disease (KD).

METHODS

Clinical data of all 26 children (22 male, 4 female) with coronary sequelae of KD who underwent CABG with RA graft at our hospital between March 2016 and September 2023 were retrospectively analyzed. The severity of coronary artery lesions was classified as Va or Vb in all patients.

RESULTS

The median (P25, P75) age of patients was 8.5 (6.0, 11.3) y and the median weight was 33.0 (21.0, 45.3) kg. The mean interval from diagnosis to operation was 5.4 ± 3.7 y. The median postoperative mechanical ventilation time was 6.0 (4.0, 12.3) h. The median intensive care unit stay was 2.0 (2.0, 3.3) d. The median length of postoperative hospital stay was 19.0 (13.0, 29.0) d. Postoperative follow-up time ranged from 0.2 to 5.8 y, and no cardiovascular-related complications occurred. Sixteen patients underwent cardiac catheterization or CT angiography during follow-up. One patient each had anastomotic stenosis in RA and right internal thoracic artery graft, respectively, while myocardial perfusion imaging showed no worsening of myocardial ischemia. There was no significant difference in forearm motor and sensory function between the operated and the contralateral arm; brachial artery angiography showed well-established forearm collateral vessels.

CONCLUSIONS

CABG is a safe and effective treatment for KD with severe coronary lesions in children. The RA graft has good early patency without impairing forearm function. Individualized surgical and anticoagulant strategies may help improve the prognosis.