Characteristic findings of coronary artery disease in Kawasaki disease.

摘要

A 46-year-old man was admitted with electrocardiographic abnormality (Q-wave in V_1 to V_4 and T-wave inversion in V_1 to V_5). Echocardiography showed left ventricular systolic dysfunction (ejection fraction: 41%) with akinetic motions of anterior and an-teroseptal wall, which corresponded to myocardial infarction of left anterior descending artery (LAD) territory. Computed tomography angiography showed noncalcified stenosis at proximal LAD (A). Conventional coronary angiography, performed 4 days later, showed a braid-like appearance with significant stenosis and aneurysmal dilation at the proximal LAD (B). Intra-vascular ultrasound revealed that this segment was composed of multiple echoic channels resembling a lotus root (thick divisions surrounded by the external elastic membrane) (C, Online Video 1), suggesting spontaneous recanalization of the thrombotic occlusion due to Kawasaki disease (1). We performed intravascular ultrasound-guided percutaneous coronary intervention with a 4.0 X 18 mm-sized everolimus-eluting stent. The patient was discharged and is doing well without adverse cardiovascular events.