Tamaki Wataru, Tsuda Etsuko, Nakajima Hiroyuki, Kobayashi Junjiro, Shiono Junko
Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan.
Pediatr Int. 2014 Apr;56(2):273-6. doi: 10.1111/ped.12253.
We describe the case of a 4-year-old boy whose clinical course after Kawasaki disease resulted in coronary artery bypass grafting (CABG) due to acute myocardial infarction (AMI) causing cardiogenic shock. He had developed an ischemic cardiomyopathy due to severe localized stenosis of the left main coronary artery (LCA) and went into cardiogenic shock due to AMI on the day before a scheduled operation. He underwent successful emergency CABG within 4 h of MI. Postoperatively his neurological status was intact. This is the first report of a successful emergency CABG in a small child with cardiogenic shock due to LCA occlusion. CABG should be undertaken in small patients when appropriate indications exist, if bodyweight is >10 kg.
我们描述了一名4岁男孩的病例,其川崎病后的临床病程因急性心肌梗死(AMI)导致心源性休克而进行了冠状动脉旁路移植术(CABG)。由于左主冠状动脉(LCA)严重局限性狭窄,他发展为缺血性心肌病,并在预定手术前一天因AMI而陷入心源性休克。他在心肌梗死发生后4小时内成功接受了紧急CABG手术。术后他的神经状态完好。这是第一例因LCA闭塞导致心源性休克的小儿成功进行紧急CABG手术的报告。当有适当指征且体重>10 kg时,小患者应进行CABG手术。