川崎病合并冠状动脉病变患儿21例冠状动脉造影复查分析
张锰, 崔青, 朱荻绮, 张玉奇, 钟玉敏, 沈捷

Coronary angiography review in 21 children with Kawasaki disease complicated with coronary artery disease
ZHANG Meng, CUI Qing, ZHU Diqi, ZHANG Yuqi, ZHONG Yumin, SHEN Jie
表1 8例冠脉病变进展的川崎病患儿的详细复查资料
Tab 1 Detailed follow-up data of 8 KD patients with progression of coronary artery lesions
No.GenderAge of diagnosisAge of first CAGEchocardiography before the first CAGResult of first CAGAge of CAG reviewResult of CAG review
1Male13 years13 years and 7 monthsA large coronary aneurysm in the LM; a large proximal coronary aneurysm in the proximal segment of LAD, and a coronary dilatation in the distal segment; a large coronary aneurysm in the proximal segment of RCAA large coronary artery aneurysm in the proximal segment of LM; a beaded dilatation in the LAD; a large coronary artery aneurysm in the proximal segment of RCA, and a post-aneurysm coronary atresia with collaterals formation17 years and 2 monthsThe LAD coronary artery aneurysm progressed and the length of the LM coronary artery aneurysm nearly doubled
2Male6 months3 years and 6 monthsSignificant enlargement of the left ventricle with LVEF of 50%; a nodule in the proximal segment of LAD; 2 sites of dilatation in the RCA without clear display of the distal segmentTorsion and stenosis of the main trunk of RCA with collaterals formation; the LAD without significant lesions7 years and 6 months (chest pain for 10 d)The proximal segment of RCA was severely narrow or atresia with several collaterals formation, and the distal segment displayed well
3Male3 years3 years and 3 monthsA large aneurysm in the proximal segment of LAD; a beaded dilatation in RCAA medium coronary aneurysm in the proximal segment of LAD and post-aneurysm coronary artery occlusion with collaterals formation; beaded dilatations in the RCA without filling defects4 years and 3 monthsThe blood flow of LCX was unobstructed; three aneurysms in the RCA progressed, of which diameters were wider than before, and filling defects could be seen in the RCA
4Male4 months4 yearsA medium aneurysm in the proximal segment of LAD and a medium aneurysm in the proximal segment of RCA, and the coronary arteries not clear after the 2 aneurysmsSmall aneurysms in the middle section of RCA with calcification and collaterals formation; stenosis in the proximal segment of LAD without coronary artery formation6 yearsThe stenosis in the LAD progressed, and the diameter of the narrowest point was 1.2 mm. Intraoperative balloon dilation was performed, and then the blood flow was unobstructed
5Female2 years and 4 months3 yearsA large aneurysm in the LM; the opening of LCX dilated with thrombosis formation; a small aneurysm in the proximal segment of RCA with thrombosis after the aneurysmA large aneurysm in the LM with the stenotic LAD; a small aneurysm at the beginning of RCA with post-aneurysm atresia and collaterals formation3 years and 9 monthsThe aneurysm in the LM progressed with narrower LAD; proximal coronary atresia of the RCA was found with collaterals formation
6Male2 years5 yearsA large aneurysm in the proximal segment LAD with thrombosis and without clear display of the distal segment; the RCA dilatated in the middle segmentThe blood flow was unobstructed in the LAD; small artery dilatations in the LAD and the distal segment of RCA7 yearsThe diameter of the opening of RCA was 3.1 mm, while the stenosis in the proximal segment was 2.01 mm in diameter, and a beaded dilatation in RCA after the stenosis
7Male9 years12 years (2 times of syncope in 3 years)The LM dilatated; a large aneurysm in the LAD; beaded dilatations in the RCAA medium aneurysm in the LAD with a post-aneurysm coronary atresia and calcification formation; 3 beaded coronary aneurysms in the RCA15 yearsThrombosis at the beginning of LAD with atresia and calcification after the thrombus; the RCA supplied the LAD by collaterals in reverse direction
8Female2 years3 yearsA large aneurysm in the LAD without clear display of the distal segmentA dilatation at the beginning of LAD, about 6.3 mm in diameter, with filling defection and thrombosis formation after the dilatation4 years and 5 monthsA aneurysm with the diameter of about 8.5 mm at the openings of LCX and LAD (bifurcation of LM)