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Thrombolytic Therapy and Long Term Follow-up Study in a Child with Kawasaki Disease Complicated by Giant Coronary Aneurysm with Thrombosis

Journal of the Korean Pediatric Society 2003;46(3):302-307.
Published online March 15, 2003.
Thrombolytic Therapy and Long Term Follow-up Study in a Child with Kawasaki Disease Complicated by Giant Coronary Aneurysm with Thrombosis
Su Jung Moon1, Su Ya Lee1, Kyong Hee Na1, Sun Young Park1, Eun Young Kim1, Kyoung Sim Kim1, Yong Wook Kim1
가와사끼병 환아에서 발생한 거대관상동맥류 내 혈전의 성공적 용해요법과 장기 치료 및 경과 1례
문수정1, 이수야1, 나경희1, 박선영1, 김은영1, 김경심1, 김용욱1
Correspondence: 
Yong Wook Kim, Email: KYW528@chollian.net
Abstract
The long-term clinical issues in Kawasaki disease are concerned with the coronary artery lesions that result in aneurysmal formation, thrombotic occlusion, progression to ischemic heart disease, and premature atherosclerosis. We here report a 3 month old infant with Kawasaki disease complicated by giant coronary aneurysm with thrombosis. After urokinase(10,000 IU/kg) and heparin(400 IU/kg) were injected for two days as thrombolytic agents, thrombi were successfully dissolved. Even though long-term oral anticoagulation with low-dose aspirin, dipyridamole and coumadin were administered, thrombosis of the left main coronary artery was slowly increased. five years later, coronary angiography showed nearly total occlusion of the left anterior descending artery and collaterals from the right posterior branch and radionuclide scan demonstrated complete reversible perfusion defect of several portions of the left ventricle.
Key Words: Kawasaki disease, Thrombosis, Giant aneurysms, Thrombolytic agents, Coronary arteries, Occlusion


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