Plain old balloon angioplasty for severe coronary artery stenosis caused by Kawasaki disease in a young child with a new aneurysm in the remote stage: a case report
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Abstract
Our patient was a 12-year-old girl who was diagnosed with Kawasaki disease at 6 months of age, which was refractory to treatment. One month after its onset, bilateral coronary artery aneurysms were confirmed via echocardiography. A stenotic lesion was then observed in the proximal portion of the aneurysm, located in the left anterior descending branch. At 2 years of age, the patient underwent plain old balloon angioplasty to treat the 99% stenosis in the left anterior descending branch caused by coronary artery lesions resulting from Kawasaki disease. This improved her stenosis to 25%. Thereafter, she was treated with aspirin and candesartan and experienced no notable symptoms or cardiovascular events. However, cardiac catheterization at 12 years of age revealed a new giant aneurysm at the plain old balloon angioplasty site. Plain old balloon angioplasty represents an effective treatment method for treating myocardial ischemia in coronary artery lesions after Kawasaki disease and can be safely performed in children. However, identification of new aneurysms after plain old balloon angioplasty is an important concern; hence, low-pressure dilation is recommended in this patient group. Despite the low-pressure dilatation performed in this case, a new aneurysm was found almost 10 years after the plain old balloon angioplasty was performed. Most new aneurysms form within 1 year after plain old balloon angioplasty; however, because new aneurysms can form even after 10 years, careful long-term follow-up is warranted.
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