Department of Oral and Maxillofacial Surgery, Stony Brook School of Dental Medicine, Stony Brook, New York.
Department of Anesthesiology, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York.
Anesth Prog. 2021 Oct 1;68(3):146-153. doi: 10.2344/anpr-68-01-06.
Kawasaki disease (KD) is an acute vasculitis of childhood and is the leading cause of acquired heart disease in children in developed countries. Failure to quickly diagnose and treat patients with KD can result in severe cardiac sequelae, especially coronary artery aneurysms (CAAs). Patients with a prior diagnosis of KD who require general anesthesia (GA) may present unique challenges depending on the severity of any cardiovascular sequelae. This case report describes the perioperative management of a 5-year-old male patient previously diagnosed with incomplete KD approximately 1 year before presenting to Stony Brook University Hospital for full mouth dental rehabilitation under GA. Most uniquely, the patient was at high risk for coronary artery thrombosis due to a giant CAA of his right coronary artery and a small CAA of his left anterior descending artery. The discussion also includes the implications of dental treatment under GA for patients with a history of KD.
川崎病（KD）是一种儿童急性血管炎，是发达国家儿童获得性心脏病的主要原因。未能及时诊断和治疗 KD 患者可导致严重的心脏后遗症，特别是冠状动脉瘤（CAA）。既往诊断为 KD 的患者需要全身麻醉（GA）时，可能会根据任何心血管后遗症的严重程度带来独特的挑战。本病例报告描述了一位 5 岁男性患者的围手术期管理，该患者在大约 1 年前被诊断为不完全性 KD，之后在 Stony Brook 大学医院接受 GA 下的全口牙齿康复治疗。最独特的是，由于其右冠状动脉的巨大 CAA 和左前降支的小 CAA，该患者存在冠状动脉血栓形成的高风险。讨论还包括了对于有 KD 病史的患者在 GA 下进行牙科治疗的影响。
