[Early and mid-term results of right gastroepiploic artery grafting in the children with Kawasaki disease].

Thirty-nine children with Kawasaki disease have undergone coronary revascularization since 1976. The attrition rate of saphenous vein grafts (SVG) was so high that we have used the internal thoracic artery (ITA) as the graft since 1984. ITA showed excellent early and mid-term patency. We, however, still had to use SVG for the distal portion of right coronary artery (RCA) and left circumflex artery (LCx) where ITA was difficult to reach. In 1988, we first successfully applied the right gastroepiploic artery (GEA) for revascularization to the posterior descending artery of a six-year-old boy. Nine children were then bypassed with the combination of ITA and GEA. GEA was anastomosed to the distal portion of RCA (7 cases) and the branch of LCx (2 cases). In 4 cases GEA showed string sign 1 month after surgery, but the angiographic finding revealed improvement after 1 year interval in 2 cases. The patency of GEA grafts was excellent after 1 month (100%:9/9) and 1 year (100%:9/9), respectively. The use of GEA in addition to ITA as the arterial graft may contribute to the improvement of long-term graft patency in revascularization of children with Kawasaki disease.