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The Fate and Observed Management of Giant Coronary Artery Aneurysms Secondary to Kawasaki Disease in the Province of Quebec: The Complete Series Since 1976

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Abstract

Most population-based series reporting on the coronary artery complications after Kawasaki disease (KD) originate from Japan. This study aimed to describe the complete series of KD patients from the province of Quebec in Canada, a predominantly Caucasian population. This retrospective case series was conducted by the Quebec Kawasaki Disease Registry, a multi-institutional collaboration reviewing 89.8 % of all KD cases identified by the Ministry of Health records of hospitalization for KD from the first recognized case in 1976 until 2008. This report describes the course of 38 patients (95 % Caucasians) with a diagnosis of giant coronary artery aneurysms, which represent 1.9 % of all reviewed cases and 26.2 % of those with a coronary aneurysm 5 mm or larger. The age at diagnosis was 5.52 ± 4.04 years, and the follow-up period was 9.26 ± 6.9 years. The KD diagnosis was retrospective at autopsy in two cases and via echocardiography in four cases. The overall freedom from coronary thrombi, coronary intervention, or death was respectively 63.9, 67.5, and 85.1 %. Five deaths occurred as follows: 21 days after onset of fever (2 cases), 1.8 months after onset of fever (1 case), 1 year after retrospectively presumed but previously undiagnosed KD (1 case), and 5.7 years after a KD diagnosis (1 case of sudden cardiac death). Percutaneous transluminal coronary revascularization was attempted in four cases (1 requiring cardiac transplantation), and two other cases underwent primary bypass graft surgery. Whereas this study investigated cases of KD with severe coronary sequelae in the Province of Quebec, larger collaborative studies should be conducted for further understanding of the disease in predominantly non-Asian populations.

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Acknowledgments

This work was partially funded by Foundation En Coeur, Foundation des enfants cardiaques du Québec.

Conflict of interest

None.

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Authors and Affiliations

  1. Division of Pediatric Cardiology, CHU Sainte-Justine, Université de Montreal, 3175, Côte Sainte-Catherine, Montreal, QC, H3T 1C5, Canada

    Ariane McNeal-Davidson, Anne Fournier & Nagib Dahdah

  2. Division of Pediatric Rheumatology, Montreal Children’s Hospital, McGill University, Montreal, QC, Canada

    Rosie Scuccimarri

  3. Division of Pediatric Cardiology, Montreal Children’s Hospital, McGill University, Montreal, QC, Canada

    Adrian Dancea

  4. Division of Pediatric Cardiology, Centre Hospitalier Universitaire de Québec, Université Laval, Quebec, QC, Canada

    Christine Houde

  5. Division of Pediatric Cardiology, Centre Hospitalier Universitaire de Sherbrooke, Université de Sherbrooke, Sherbrooke, QC, Canada

    Marc Bellavance

Authors
  1. Ariane McNeal-Davidson
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  2. Anne Fournier
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  3. Rosie Scuccimarri
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  4. Adrian Dancea
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  5. Christine Houde
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  7. Nagib Dahdah
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Corresponding author

Correspondence to Nagib Dahdah.

Additional information

This study was conducted on behalf of the Quebec Kawasaki Disease Registry collaborative group.

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McNeal-Davidson, A., Fournier, A., Scuccimarri, R. et al. The Fate and Observed Management of Giant Coronary Artery Aneurysms Secondary to Kawasaki Disease in the Province of Quebec: The Complete Series Since 1976. Pediatr Cardiol 34, 170–178 (2013). https://doi.org/10.1007/s00246-012-0409-2

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  • DOI: https://doi.org/10.1007/s00246-012-0409-2

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