Takashi Kosuda

Giant Coronary Aneurysm of Kawasaki Disease Developing During Postacute Phase

The patient suffered from Kawasaki disease at 5 months of age. The first angiography, performed 14 months after the onset of disease, showed a right coronary aneurysm with a maximal diameter of 6 mm and normal left coronary artery (Figure 1⇓). Dipyridamole and propranolol were given as antiplatelet therapy and for reduction of myocardial oxygen consumption, respectively. The second angiography, performed 6 years later, revealed enlargement of the right coronary aneurysm, with a maximal diameter of 15 mm (Figure 2⇓). Treatment with dipyridamole and …

Assessment of left ventricular function in Kawasaki disease by dipyridamole-loading cineventriculography

Dipyridamole-loading cineventriculography was performed to evaluate left ventricular (LV) function in 76 patients with Kawasaki disease. Forty-five of 76 patients underwent the procedure within 6 months from the onset of illness (group 1A, normal findings on coronary angiogram; group 1B, maximal diameter of coronary lesions less than 4 mm; group 1C, maximal diameter of coronary lesions greater than 4 mm). Thirty-one of 76 patients underwent the procedure greater than 6 months after onset (group 2A, coronary lesions improved to normal or less than 4 mm; group 2B, remaining coronary lesions greater than 4 mm; group 2C, stenosis or obstruction of the coronary artery). Global LV ejection fraction increased in groups 1A, 1B and 2A after infusion of dipyridamole, but there was no significant change in groups 1C, 2B and 2C. In analyzing LV excursion, the pattern of LV wall motion with dipyridamole in groups 1B and 2A were similar to that in group 1A, but in 38% (5 of 13) of group 2A patients, abnormal regional LV wall motion after administration of dipyridamole was detected. Abnormal LV wall motion after dipyridamole infusion was detected in 42% (5 of 12) of group 1C patients, 38% (3 of 8 cases) of group 2B patients and 70% (7 of 10 cases) of group 2C patients. In conclusion, analysis of LV wall motion with dipyridamole is useful in evaluating cardiac involvement in Kawasaki disease.

[Ventricular septal defect associated with pulmonary hypertension in monozygotic twins--a case report with surgical repair].

This is a report of two-year-old female monozygotic twins, both having a ventricular septal defect (VSD, Kirklin type II) and accompanying moderate pulmonary hypertension (PH). The two patients underwent a patch closure procedure to repair the VSD at the same time, and their postoperative courses were uneventful. Rubenstein and Weaver have reported the only case of surgical treatment for monozygotic twins having both VSD and PH. Our patients are the second such case of surgical treatment of VSD and PH in monozygotic twins.