Q:

Indications for surgical intervention in Kawasaki's disease include which of the following?

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Indications for surgical intervention in Kawasaki's disease include which of the following?


  1. The presence of multiple coronary artery aneurysms.
  2. Myocardial infarction and severe left ventricular dysfunction.
  3. The presence of a 5 mm. aneurysm in the right coronary artery
  4. Progressive stenosis in the left anterior descending coronary artery.
  5. None of the above.

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D. Progressive stenosis in the left anterior descending coronary artery.

DISCUSSION: The indications for surgical treatment of Kawasaki's disease include: (1) progressively stenotic coronary lesions demonstrated on coronary arteriography, with no distal coronary aneurysms with stenosis; (2) localized aneurysm with significant stenosis in the left main coronary artery; (3) significant stenosis in two coronary arteries; (4) presence of collateral vessels arising from a coronary artery with a proximal aneurysm; (5) progressive stenosis in the left anterior descending coronary artery; and (6) presence of a left ventricular aneurysm. Advanced thrombosis of coronary aneurysms causing critical stenoses in multiple coronary arteries is the most common indication for surgical intervention.

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