Myocardial contrast echocardiography of coronary artery lesions due to Kawasaki disease.

In addition to coronary arteriography, myocardial contrast echocardiography (MCE) was performed in 25 patients with coronary artery lesions due to Kawasaki disease, in order to investigate its validity in the evaluation of these lesions and its safety in children. The patients' ages ranged from 1.0 to 15.9 years (mean, 8.6 years). Their coronary artery lesions included occlusion in 9 branches (9 patients), segmental stenosis in 9 (8 patients), localized stenosis in 16 (12 patients), and dilated lesions without coexistent stenotic lesions in 5 patients. Seven patients had coronary artery bypass grafts. Myocardial perfusion patterns of the stenotic lesions and coronary artery bypass grafts could be clearly demonstrated by MCE. For the assessment of safety, electrocardiograms obtained at the time of MCE and coronary arteriography in 14 patients showed no significant difference in the findings between MCE and coronary arteriography. Serum glutamic oxaloacetic transaminase, glutamic pyruvic transaminase, lactic dehydrogenase, and creatine phosphokinase levels were measured before and 1 day after the procedure in 14 patients who underwent MCE and coronary arteriography, and in a group of 14 patients who underwent coronary arteriography alone. No significant difference was noted between the values of the two groups. These results suggested that MCE can be utilized in the assessment of coronary artery lesions due to Kawasaki disease, and confirmed the safety of the procedure even in young children.